• Carles Blay, Joan Carles Martori, Esther Limón, Ramon Oller, Laura Vila, and Xavier Gómez-Batiste.
• Cátedra de Cuidados Paliativos, Universitat de Vic-Universitat Central de Catalunya, España; Institut Català de la Salut, Mataró, España. Electronic address: carlesblay.dr@gmail.com.
• Aten Primaria. 2019 Feb 1; 51 (2): 717971-79.

ObjectiveTo determine the prevalence and profiles of people with advanced chronic diseases in Primary Care and to analyse the elements related to their mortality in order to orient strategies for improvement in this level of care.DesignAn observational, analytical and prospective study during 3 years conducted on a cohort of patients with palliative needs.LocationThree Primary Care teams of Osona (Catalonia).ParticipantsA total of 251 people identified as advanced patients using a systematic population-based strategy that included the NECPAL tool.Main MeasurementsBasic demographic and clinical profile (age, gender, type of residence, health stratification level and main disease); date, place, and cause of eventual deaths.Results1% of the adult Primary Care population suffer from advanced diseases, of which 56.6% are women, and with a median age of 85 years. Dementia or advanced frailty is observed in 49.3%, and only 13.7% have cancer. Just under one-quarter (24.3%) live in nursing homes. The accumulated mortality at 3 years is 62.1%, with a median survival of 23 months. Factors significantly associated with the likelihood of dying are cancer, female gender, and over-aging. Patients died at their home (47.3%), in an intermediate care hospital (37.2%), or in an acute care hospital (15.5%), depending on certain explanatory factors.ConclusionsThe prevalence and characteristics of advanced community-based disease coincide with that reported in the literature. Potentially, Primary Care is the reference level of care for these patients, especially if it incorporates nursing homes as a usual field of practice.Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

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