OBJECTIVES:
1. To describe hospital use for people in their last year of life who died of cancer and non cancer conditions
2. To compare the effect of community-based specialist palliative care on hospital use for different groups
METHOD:
This retrospective cross-sectional study is based on death registrations, morbidity data and community-based palliative care data for 1071 Western Australians who
died of cancer and non-cancer conditions considered amenable to palliative care, had an informal primary carer and did not live in a residential aged care facility. The
proportion in hospital on any one day over the last 365 days of life is reported.
Demographics
Number of hospital admissions in the last year of life
Non Cancer
100%
90%
80%
70%
Cancer
70%
60%
Yes
49%
>75
50%
Male
63%
65-75
25%
30%
20%
Non Cancer
30%
10%
No
51%
<65
25%
Female
37%
0%
Cancer Status
Age Group
Received SPC
Gender
Total
No admissions
22
6.8%
20
2.7%
42
4%
1-2 admissions
126
38.8%
169
22.7%
295
28%
3-5 admissions
111
34.2%
203
27.2%
314
29%
6-10 admissions
37
11.4%
176
23.6%
213
20%
More than 10
29
8.9%
178
23.9%
207
19%
50%
40%
Cancer
admissions
RESULTS
Total hospital admissions for the 1,072 decedents = 8,3550 (mean: 7.8,
median: 4.0)
Mean number of days in hospital = 5.6 days
People with non-cancer conditions had more admissions and days in hospital
than those with cancer
Two thirds of decedents were in hospital on the day they died
Those accessing community-based specialist palliative care spent less time in
hospital in the last 90 days of life
CONCLUSION
Western Australian hospitals currently provide extensive and progressively
greater care at the end of life. Identifying patterns of inpatient use for cancer and
non cancer conditions considered amenable to palliative care will assist in the
planning of appropriate services for people where death is an expected outcome.
This study illustrates that those receiving community-based specialist palliative
care spend less time in hospital, particularly in the last 90 days of life.
PROFESSOR BEVERLEY MCNAMARA AND PROFESSOR LORNA ROSENWAX
SCHOOL OF OCCUPATIONAL THERAPY & SOCIAL WORK