Achieving needs-based end-of-life services: A prospective, longitudinal study of pathways for advanced cancer patients

Project dates:
Commenced: 2011
Completed: 2013

Providing effective and sustainable palliative care services (PCS) is of increasing concern for governments and health systems worldwide. The objective of this prospective, longitudinal study was to track and quantify patients’ movements through health services over their last 6 months of life. Data were collected for 6 months (or until death, whichever was sooner) from self-report questionnaires; patient-held diaries; and from state and commonwealth administrative health records. Critical events (inpatient admissions and emergency department presentations (EDP)) were examined and rated by Oncology and Specialist Palliative Care Consultants.

Project outcomes:

Twenty-eight (of the n=50) patients collectively recorded 40 EDP; 17 occurred afterhours (45%), four on weekends (11%) and 33 EDP resulted in admissions (83%). Seventy-nine inpatient admissions were collectively recorded across 30 patients; 14 occurred on weekends (18%). The median length of stay of all admissions was four days (range 1-31 days). Seven critical events were rated as ‘preventable’.