Characterization of the Home Care Program of the Pain Control and Palliative Care National Center of Costa Rica, January 2017 to August 2021

Abstract

Objective: characterize the Home Care Program (PAD) of the National Center for Pain Control and Palliative Care (CNCDYCP) of Costa Rica. Methodology: retrospective descriptive study that contemplated the official database of the CNCDYCP PAD of January 2017 until August 2021, including a population of 1869 people who were first admitted to the program by a diagnosis of cancer disease, non -oncological disease and Amyotrophic Lateral Sclerosis. In addition, two surveys were applied to the professionals who gave the palliative care in the institution and professionals from different disciplines that execute home visits in this institution. Results: the CNCDYCP PAD added during the study period 1869 new people admitted that met inclusion criteria in the San José area and the people diagnosed with amyotrophic lateral sclerosis throughout the country. Ninety one percent of people concentrated in San José, a province that demographically is the largest population. The most frequent cause of income was oncological diseases (68%), neurodegenerative diseases with (14.6%) and advanced chronic diseases (10.9%). According to the degree of complexity and the required needs, it was allowed to locate that the majority are those with oncological and red category (45.7%), which require priority attention in less than a week. The PAD was incorporated into the CNCDYCP since 1991, in charge of a coordinator nurse, a general nurse and the support of the palliative medical doctor of the external consultation; as well as three home care teams (nurse, doctor and driver). Specialized therapies (physical therapy, respiratory therapy, social work, nutrition and psychology) provide attention according to the need of people attended, who make visits once a week with a scheduled agenda. The criteria for identified PAD are advanced phase cancer, chronic terminal disease with functional limitation or social problem to move, amyotrophic lateral sclerosis, terminal disease with limited life condition, present some real impediment that prevents moving to the center of attention; Belong to the region or area of attraction to visit, in addition to other specific criteria for pathology. Conclusion: the CNCDYCP PAD has more than two decades to provide attention in this modality, attending to a population mainly from older adults and diagnosed with oncological diseases in the red category of care priority. The description of this program allowed knowing the basis of its consolidation as an institutional entity and being a frame of reference for the understanding of the home scenario in Costa Rica.