Who needs, receives and misses out on palliative and end-oflife care? A population-based study to identify needs and gaps in a regional health service

• Published in: Australian health review 2022-02, Vol.46 (1), p.91-99
• Main Authors: Westley-Wise, Victoria, Moules, Stephen, Masso, Malcolm, Barclay, Greg, Nangati, Zivai, Allingham, Sam, Davis, Joanne, Eagar, Kathy
• Format: Article
• Language: English
• Subjects: Cancer; Chronic illnesses; Codes; Datasets; Estimates; Health services; Hospitals; Linked Data; Palliative care; Patients; Population; Population-based studies; Sociodemographics; Socioeconomic factors
• ISSN: 0156-5788; 1449-8944
• DOI: 10.1071/AH21052

Objective. The aim of this study was to assess the unmet need for palliative and other end-of-life care, as well as the sociodemographic and diagnostic factors associated with suboptimal access, among residents in an Australian region. Methods. A cross-sectional descriptive and analytical study was performed using non-identifiable linked data from four administrative and two clinical datasets. The study population comprised 3175 patients aged >15 years who died in hospital in 2016 and 2017. The main outcome measures were the proportion of decedents potentially benefitting from endof-life care and receiving end-of-life care. Results. An estimated 74.8% of decedents needed palliative or other end-of-life care in the year before death. Approximately 13.3% did not receive any end-of-life care despite its potential benefit. The highest proportions with 'unmet need' were decedents with chronic obstructive pulmonary disease (31.0%) andheart failure (26.3%). Adjusting for sociodemographic and diagnostic factors, access was lowest among those aged