BACKGROUND PaTz (palliative care at home) is a method to improve palliative care in the primary care setting in the Netherlands. PaTz has three basic principles: (1) local GPs and DNs meet at least six times per year to identify and discuss their patients with a life-threatening illness; (2) these meetings are supervised by a specialist palliative care professional; (3) groups use a palliative care register on which all identified patients are listed. Since the start in 2010, the number of PaTz-groups in the Netherlands has been growing consistently. Although the theory of all PaTz-groups is the same, the practical functioning of PaTz-groups may vary substantially, which may complicate further implementation of PaTz as well as interpretation of effect studies. This study aims to describe the variation in practice of PaTz-groups in the Netherlands. METHOD In this prospective observational study, ten PaTz-groups logged and described the activities in their meetings as well as the registered and discussed patients and topics of discussions in registration forms for a 1 year follow-up period. In addition, non-participatory observations were performed in all participating groups. Meeting and patient characteristics were analysed using descriptive statistics. Conventional content analysis was performed in the analysis of topic discussions. RESULTS While the basic principles of PaTz are found in almost every PaTz-group, there is considerable variation in the practice and content of the meetings of different PaTz-groups. Most groups spend little time on other topics than their patients, although the number of patients discussed in a single meeting varies considerably, as well as the time spent on an individual patient. Most registered patients were diagnosed with cancer and patient discussions mainly concerned current affairs and rarely concerned future issues. CONCLUSION The basic principles are the cornerstone of any PaTz-group. At the same time, the observed variation between PaTz-groups indicates that tailoring a PaTz-group to the needs of its participants is important and may enhance its sustainability. The flexibility of PaTz-groups may also provide opportunity to modify the content and tools used, and improve identification of palliative patients and advance care planning.

中文翻译：

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PaTz实施中的差异：在一般实践中改善姑息治疗的方法-前瞻性观察研究。

背景技术PaTz（在家中的姑息治疗）是一种在荷兰的初级保健环境中改善姑息治疗的方法。PaTz具有三项基本原则：（1）本地GP和DN每年至少开会六次，以识别和讨论他们的危及生命的患者；（2）这些会议由姑息治疗专家进行监督；（3）组使用姑息治疗登记簿，其中列出了所有已识别的患者。自2010年开始以来，荷兰的PaTz团体数量一直在持续增长。尽管所有PaTz-组的理论都相同，但是PaTz-组的实际功能可能会有很大的不同，这可能会使PaTz的进一步实施和效果研究的解释变得复杂。这项研究旨在描述荷兰PaTz小组在实践中的差异。方法在这项前瞻性观察性研究中，十个PaTz组记录并描述了他们的会议活动以及注册和讨论的患者以及讨论形式的讨论主题，为期1年。此外，在所有参与组中均进行了非参与性观察。使用描述性统计数据分析会议和患者特征。在主题讨论的分析中执行了常规的内容分析。结果尽管PaTz的基本原理几乎在每个PaTz组中都可以找到，但是不同PaTz组的会议的实践和内容存在很大差异。尽管在一次会议中讨论的患者人数相差很大，但大多数小组都在患者身上花了很少的时间在其他话题上，以及花在每个病人身上的时间。大多数注册患者被诊断出患有癌症，患者讨论主要涉及当前事务，很少涉及未来问题。结论基本原理是任何PaTz组的基石。同时，观察到的PaTz组之间的差异表明，根据参与者的需求量身定制PaTz组很重要，并且可以增强其可持续性。PaTz组的灵活性还可能提供机会来修改所使用的内容和工具，并改善对姑息性患者的识别和提前进行护理计划。结论基本原理是任何PaTz组的基石。同时，观察到的PaTz组之间的差异表明，根据参与者的需求量身定制PaTz组很重要，并且可以增强其可持续性。PaTz组的灵活性还可能提供机会来修改所使用的内容和工具，并改善对姑息性患者的识别和提前进行护理计划。结论基本原理是任何PaTz组的基石。同时，观察到的PaTz组之间的差异表明，根据参与者的需求量身定制PaTz组很重要，并且可以增强其可持续性。PaTz组的灵活性还可能提供机会来修改所使用的内容和工具，并改善对姑息性患者的识别和提前进行护理计划。