What does state-level inpatient palliative care data tell us about service provision?

ABSTRACT

BACKGROUND: Palliative care is increasingly seen as an integral component of care for patients with advanced malignant and nonmalignant illness. Clinical audit data can provide important insights into patient care, but limited published data are available investigating statewide palliative care provision issues. OBJECTIVES: Our aim was to provide a comprehensive perspective on inpatient palliative care within a populous Australian state, and highlight potential gaps in service provision. METHODS: Descriptive analysis was conducted of the Victorian Admitted Episodes Dataset (VAED, a comprehensive database of inpatient activity from all hospitals in Victoria). Variables analyzed included overall number of separations, average length of stay, referral source, age profile, and indigenous status. RESULTS: The mean length of stay for patients in Victorian inpatient palliative care settings was 12.8 days, and there were 6004 separations reported over an 11 month period from approximately 264 designated palliative care beds in the state. The mode of separation for the majority of admissions to inpatient palliative care was death (65%). Few patients resided outside metropolitan regions, and no patients admitted identified as Aboriginal and/or Torres Strait Islander (the indigenous communities of Australia). CONCLUSION: The pooled epidemiological data reviewed identify a number of areas of interest including the lack of Aboriginal Australians identified and accessing inpatient palliative care, and variations in inpatient care across geographical areas. This highlights issues of access and equity of access to inpatient palliative care.