Introduction: The General Practitioner (GP), thanks to his knowledge of the patient's bio-psycho-social context, has a fundamental role in the definition of a personalized care planning (Pcp). The HexCom model can be a valid tool for standardizing the level of complexity of the patient in palliative care and for evidentiate critical care issues.
Methods: The GP participants retrospectively assessed, using HexCom model, the complexity of the biopsycho-social context of 53 patients taken care by the Palliative Care Unit and who died in the years 2019-2021. For each patient, age, sex, treating doctor, main diagnosis, data and place of death (home/hospice/hospital) were collected.
Results: Subjects who died in hospital or hospice had similar HexCom complexity scores, higher than those who died at home (p=0.04). The HexCom score was inversely related to the subject's age (p=0.01). The ROC curve suggested a cut-off for HexCom equal to 209, whereby subjects with HexCom ≥209 would be associated with death in hospital/hospice while subjects with HexCom <209 would be associated with death at home.
Conclusion: The present study confirms the importance of evaluating the complexity of a patient in palliative care and proposes the use of the HexCom model for the evaluation of the biopsycho-social context, a predictor of the outcome of a patient in palliative care.
Key words: bio-psycho-social, complexity, GP, HexCom, palliative care, Pcp.