Introduction: There is evidence of high levels of unmet palliative care need in Australia and internationally. Early access to palliative care is associated with improved outcomes including improved quality of life and reduced healthcare costs.
Aim and Objectives: The aim of this study was to gain an understanding of palliative care need and service utilisation in an adult inpatient setting. The objectives were to 1) Determine the size and characteristics of the population of adult inpatients who were appropriate for palliative care referral, 2) Establish what percentage of patients, who were appropriate for a palliative care referral, had been referred to and/or were receiving palliative care.
Methods: An observational point prevalence study was conducted. Data were collected directly from adult inpatient medical records for patients admitted on 3rd June 2021. Patients <18 years old, maternity patients and patients admitted for a same day procedure were excluded from the study cohort. Palliative care need was assessed using the prognostic criteria for the 12 conditions outlined in the Gold Standards Framework (GSF).
Results: Two hundred and seventy inpatients met study inclusion criteria. At a hospital population level, 29% (n=78) of adult inpatients met GSF criteria that indicated a need for palliative care. Of the 78 patients assessed as meeting criteria for palliative care, 29% (n=23) were currently receiving palliative care with a majority of patients 71% (n=55) not receiving palliative care. Unmet palliative care was evident for most conditions outlined in the GSF and across specialities.
Implications for Practice: The estimate of palliative care need obtained through this point prevalence study will be used to improve access to palliative care services and to assess the operational requirements, including the staffing levels required to meet the level of palliative care need for adult inpatients.
Conclusion: Our review of adult inpatients found a high prevalence of palliative care need. There was also evidence of a high level of unmet palliative care need across conditions and inpatient specialities.
Conflict of Interest: None to declare.
Funding Acknowledgement: This study was supported by St John of God Subiaco Hospital with a total of $2680.50 in funding.