{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T17:23:52Z","timestamp":1754155432456,"version":"3.41.2"},"reference-count":25,"publisher":"Emerald","issue":"1","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JICA"],"published-print":{"date-parts":[[2025,3,11]]},"abstract":"<jats:sec><jats:title content-type=\"abstract-subheading\">Purpose<\/jats:title><jats:p>Created in 2006 to provide healthcare and social support to dependent patients in Portugal, the National Integrated Continued Care Network (NICCN) has been unable to tackle a growing demand, as the population ages with high dependency indices and social resources are scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Design\/methodology\/approach<\/jats:title><jats:p>The study involved a retrospective cohort study of adult patients referred to the NICCN by a Portuguese university hospital in 2022, with sociodemographic and clinical characterization of patients and analysis of the referral process, outcomes and one-year survival after referral.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Findings<\/jats:title><jats:p>A total of 916 patients were referred but only 579 were admitted. Patients referred by the Palliative Care Department (PCD, <jats:italic>n<\/jats:italic>\u00a0=\u00a0100) were younger and 64% had a cancer diagnosis, compared to 8% of patients referred by the Senior Management Team (<jats:italic>n<\/jats:italic>\u00a0=\u00a0816), among whom stroke and trauma prevailed. The median time from referral to acceptance was 5\u00a0days for patients referred by PCD and 14\u00a0days for others. One-third of referrals were rejected\/cancelled and 50% of corresponding patients died within a year, as did 35% of those admitted to the NICCN. Most patients referred by PCD died within 4\u00a0months of referral, 47% of them before admission to the NICCN.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Practical implications<\/jats:title><jats:p>The referral process to the NICCN is time-consuming and many patients die or are discharged while waiting for a place. The high proportion of deaths within the first year after referral and within a few months for patients referred by the PCD suggests that the NICCN as a whole could benefit from a specialised palliative care intervention, which should take place earlier.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Originality\/value<\/jats:title><jats:p>Apart from estimates on the number of vacancies in NICCN and waiting time trends, no previous research evaluated the outcomes and efficiency of this process.<\/jats:p><\/jats:sec>","DOI":"10.1108\/jica-08-2024-0045","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T05:29:09Z","timestamp":1735622949000},"page":"34-50","source":"Crossref","is-referenced-by-count":0,"title":["Trajectory and outcomes of patients referred from a Portuguese university hospital to the national integrated continued care network: retrospective 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