History
The La Paz University Hospital, part of the Autonomous University of Madrid, was opened in 1961 as part of the hospital network of the National Health System. It is the referral hospital for an area with a population of 750,000. This prestigious hospital is widely recognised for its range of specializations.
Profile
The La Paz University Hospital has around 1,300 beds in four buildings: a General Hospital, Rehabilitation and Trauma Hospital and a Children’s and Maternity Hospital. There are 45 operating theatres and we have 7,000 qualified employees. There are about 50,000 admissions annually, more than 200,000 patients are treated by the emergency services, and more than 1,300,000 outpatients are seen. There are medical and nursing students (both pre-graduate and postgraduate) and we also host the La Paz Medical Research Institute (IdiPAZ).
The Palliative Care Unit (PCU) has three sections: Inpatient Unit (IU). Hospital Support Team (HST), which acts as an internal consultant for the different hospital services, and the Outpatient Clinic (OC). The PCU is in the General Hospital. IU has 13 beds in single rooms for patients in advanced stages of disease presenting acute symptomatic problems. The IU accepts patients with non-oncological diseases, however, 85% of the patients admitted to the Unit show cancer as the underlying pathology. Admissions to the IU comes from other areas of the hospital, inpatients, outpatients, from the Emergency Department or are derived directly from the home through the PHCTs. The IU receives about 500 admissions annually, with an average stay of less than 10 days.
Specialties
Oncological patient care takes place in the Medical Oncology Service, the Radiotherapy Medical Service and in the Palliative Care and Symptom Control Unit. The Medical Oncology Service has a Translational Oncology Unit and a Clinical Trials Unit. The Oncology Department interacts with all the other services and units in the La Paz University Hospital.
The Medical Oncology Service is divided into two clinical areas, each one dedicated to particular tumour pathology. Each year, 8,640 patients receive periodic follow-ups, 14,400 receive chemotherapy, while 1,600 new patients are added. There are 1,300 admissions per annum to the Medical Oncology Department
Palliative and Supportive Care
The Hospital Support Team (HST) works on demand, with the departments handling the patient with the aim of improving biopsychosocial symptoms and the overall quality of life of patients with advanced illness. It also identifies the best clinical location for the patient through the coordination with the Palliative Home Care Teams (PHCTs) and Medium-Term Palliative Care Units (hospices) located in support units. Like the Inpatient Unit (IU), it also accepts internal consultations of oncological and non-oncological patients with advanced disease criteria and/or acute symptomatic problems. 80% of the patients treated are oncological patients. There is an average of about 1200 internal consultations annually.
We focus on early integration in the disease course, concurrent with active treatment, we promote the external consultation of palliative care. Patients are referred from oncologic outpatient clinic or, more frequently, when patients are discharged from oncologic hospitalization unit (if they have been admitted from emergency services). OC have grown exponentially. There is an average of 1,500 consultations per year, of which 350 correspond to new patients. In the case of glioblastomas and head and neck tumors, we have started specific integrated follow-up programs from the diagnosis of advanced disease. These programs are within the framework of research studies that aim to determine the best time to integrate palliative care in the trajectory of each neoplasm.
The PHCTs cover the entire population of the catchment area. It has been operating for over 25 years. In total, there are six physicians, six nurses, one nursing assistant, two psychologists, a social worker, and a number of part-time administrative staff. The mission of the PHCTs is to assist primary care physicians in monitoring patients who meet the established criteria for terminal illness. The referral of these patients is mainly from the Palliative Care Unit in the Hospital, or from primary care physicians. In this way, we try to optimize the services. Patients who can be followed up in the hospital go to outpatient consultations, while those who are functionally worse are referred for home follow-up. The PHCTs are functionally linked to Primary Care to facilitate coordination between Primary Care Teams, and other hospital services. Monitoring of patients at home is performed in coordination with the appropriate family doctor to optimize the care provided by the teams and not to supplant the primary care network. The PHCTs serve about 1200 patients annually, with a median of 48 follow-up days.
Additional contact
Alberto Alonso Babarro, MD. PhD - E-mail
Last update: December 2022
