How difficult is changing the trajectory of patients with progression of their life-shortening diseases within the care of emergency medical services?

Abstract

Home would be preferred place of end-of-life care for eighty per-cent of the Czech population. However, the reality is quite the opposite: 60 % of deaths occur in hospitals and 19 % in social services institutions.

There is neither relevant clinical nor economical explanation for the fact that anticipatable deaths related to life-shortening diseases occur mostly during short-term, terminal acute hospitalization. Following an increased public interest, dying in Czechia is now undergoing a significant change.

This case series study shows that clinical decision-making of the medical dispatching and field response units can play a crucial role in endof- life trajectories.