Circumstances of hospital admissions in palliative care: A cross-sectional survey of patients admitted to hospital with palliative care needs

Background: On average, people will experience 2.28 hospital admissions in the last year of life with the likelihood of a hospital admission increasing in the last 2 weeks of life. Reducing hospital admissions has become a focus for high-income countries as they work to manage the financial implicat...

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Bibliographic Details
Published in:Palliative medicine 2018-05, Vol.32 (5), p.1030-1036
Main Authors: Robinson, Jackie, Gott, Merryn, Frey, Rosemary, Ingleton, Christine
Format: Article
Language:English
Subjects:
Cancer
Community services
Cross-sectional studies
Home health care
Hospice care
Hospitalization
Illnesses
Medical diagnosis
Motivation
Needs
Palliative care
Patient admissions
Patients
Polls & surveys
Quality of care
Research design
Treatment methods
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Summary:Background: On average, people will experience 2.28 hospital admissions in the last year of life with the likelihood of a hospital admission increasing in the last 2 weeks of life. Reducing hospital admissions has become a focus for high-income countries as they work to manage the financial implications of an ageing population. However, the circumstances by which patients with palliative care needs are admitted to hospital remain poorly understood. Aim: To explore the circumstances of hospital admissions for patients with palliative care needs. Design: Cross-sectional survey design using face-to-face questionnaires. Setting/participants: In total, 116 patients aged >18 years admitted to a tertiary hospital with palliative care needs. Results: Those with a non-cancer diagnosis and those aged over 75 years were less likely to have hospice involved prior to the admission (x2 (1, n = 116) = 10.19, p = 0.00). Few patients recognised community services as having a role in enabling them to remain at home. Those with cancer placed a significantly higher priority on receiving information about their illness (t(114) = 2.03, p = 0.04) and receiving tests and investigations (t(114) = 2.37, p = 0.02) in hospital. Conclusion: This study has demonstrated the complexity of hospital admissions in palliative care. Further research is needed to explore patient perceptions of care at home and the role of community services to enable them to remain at home. Understanding the motivation to come to hospital in the context of an incurable illness and limited treatment options may help to inform the development of services that can enable better care at home.
ISSN:0269-2163
1477-030X
DOI:10.1177/0269216318756221