Patient Journey in Palliative Care Within the NOVO Hospital Group.

Population aging and the increasing prevalence of chronic diseases and frailty have led to a growing demand for palliative care. End-of-life trajectories are frequently complex and involve multiple transitions between hospital care, home, and long-term care facilities. In many healthcare systems, a large proportion of healthcare expenditures in the last months of life is related to hospitalizations. A better understanding of the characteristics and care pathways of patients receiving palliative care is therefore essential to improve the organization and coordination of end-of-life care.

In France, general practitioners play a key role in the follow-up of patients and in coordinating care between hospital and community settings. However, the identification of palliative care needs and the timing of referral to specialized palliative care services remain heterogeneous. Improved knowledge of patient profiles and care trajectories may help identify opportunities to strengthen collaboration between hospital teams and primary care physicians.

This retrospective monocentric descriptive study will analyze patients identified as receiving palliative care who died in 2024 within the NOVO Hospital network. Data will be extracted from the medical record system and anonymized prior to analysis.

Collected variables will include sociodemographic characteristics, clinical information such as comorbidities, level of autonomy, and data related to the organization of care. Particular attention will be given to the involvement of general practitioners, the use of specialized palliative care teams, and access to home-based care services. The study will also examine healthcare utilization in the last months of life, including hospital admissions and emergency department visits, as well as end-of-life conditions such as the place of death, the presence of advance directives, and the use of continuous deep sedation.

By describing patient profiles and care trajectories, this study aims to identify potential factors associated with healthcare utilization and to highlight opportunities to improve early palliative care identification and coordination between hospital and community care.

Inclusion criteria

• Patients who died between January 1, 2024, and December 31, 2024, in the hospital or in their personal living space (home, nursing home...)
• Having "palliative care" status in their medical record
• Receiving care at one of the six NOVO hospital sites (Pontoise, Magny-en-Vexin, Beaumont-sur-Oise, Marines, Saint-Martin-du-Tertre, Aincourt)
• Whether or not they were followed by a mobile palliative care team

Exclusion criteria

None