Early admission to community-based palliative care reduces use of emergency departments in the ninety days before death

McNamara, BA; Rosenwax, LK; Murray, K; Currow, DC

Early admission to community-based palliative care reduces use of emergency departments in the ninety days before death

McNamara, BA Rosenwax, LK Murray, K Currow, DC

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Publication Type:: Journal Article
Citation:: Journal of Palliative Medicine, 2013, 16 (7), pp. 774 - 779
Issue Date:: 2013-07-01

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Field	Value	Language
dc.contributor.author	McNamara, BA	en_US
dc.contributor.author	Rosenwax, LK	en_US
dc.contributor.author	Murray, K	en_US
dc.contributor.author	Currow, DC https://orcid.org/0000-0003-1988-1250	en_US
dc.date.issued	2013-07-01	en_US
dc.identifier.citation	Journal of Palliative Medicine, 2013, 16 (7), pp. 774 - 779	en_US
dc.identifier.issn	1096-6218	en_US
dc.identifier.uri	http://hdl.handle.net/10453/117422
dc.description.abstract	Background: Overcrowded emergency departments (EDs) and the staff within them are often not able to address the complex physical and psychosocial needs of people at the end of life. While some studies have suggested that the ED environment should be adapted and staff trained to address this issue, there are no previous studies which have investigated whether the provision of timely palliative care services could prevent people with palliative care needs from attending EDs. Objective: This study investigates whether early admission to community-based palliative care reduces ED admissions in the last 90 days of life for patients with cancer. Methods: The study was a retrospective, cross-sectional study using death registrations and hospital morbidity data for 746 Western Australian adults who died of cancer and where palliative care may have been a viable and appropriate option for care. Results: In their final 90 days before death, 31.3% of decedents who had early access to palliative care and 52.0% of those who did not have early access to palliative care visited an ED (OR=2.86; 95% CI, 1.91, 4.30). Early admission to community-based palliative care reduces the use of EDs by cancer patients in the 90 days before death. Conclusions: Proactive care in the form of timely community-based palliative care assists in preventing vulnerable people at the end of life from being exposed to the stressful ED environment and decreases the pressure on EDs. © Mary Ann Liebert, Inc.	en_US
dc.relation.ispartof	Journal of Palliative Medicine	en_US
dc.relation.isbasedon	10.1089/jpm.2012.0403	en_US
dc.subject.classification	Gerontology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Neoplasms	en_US
dc.subject.mesh	Patient Admission	en_US
dc.subject.mesh	Palliative Care	en_US
dc.subject.mesh	Death Certificates	en_US
dc.subject.mesh	Cause of Death	en_US
dc.subject.mesh	Logistic Models	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Cross-Sectional Studies	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Terminally Ill	en_US
dc.subject.mesh	Emergency Service, Hospital	en_US
dc.subject.mesh	Community Health Services	en_US
dc.subject.mesh	Western Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Young Adult	en_US
dc.subject.mesh	Workforce	en_US
dc.title	Early admission to community-based palliative care reduces use of emergency departments in the ninety days before death	en_US
dc.type	Journal Article
utslib.citation.volume	7	en_US
utslib.citation.volume	16	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.issue	7	en_US
pubs.publication-status	Published	en_US
pubs.volume	16	en_US

Abstract:

Background: Overcrowded emergency departments (EDs) and the staff within them are often not able to address the complex physical and psychosocial needs of people at the end of life. While some studies have suggested that the ED environment should be adapted and staff trained to address this issue, there are no previous studies which have investigated whether the provision of timely palliative care services could prevent people with palliative care needs from attending EDs. Objective: This study investigates whether early admission to community-based palliative care reduces ED admissions in the last 90 days of life for patients with cancer. Methods: The study was a retrospective, cross-sectional study using death registrations and hospital morbidity data for 746 Western Australian adults who died of cancer and where palliative care may have been a viable and appropriate option for care. Results: In their final 90 days before death, 31.3% of decedents who had early access to palliative care and 52.0% of those who did not have early access to palliative care visited an ED (OR=2.86; 95% CI, 1.91, 4.30). Early admission to community-based palliative care reduces the use of EDs by cancer patients in the 90 days before death. Conclusions: Proactive care in the form of timely community-based palliative care assists in preventing vulnerable people at the end of life from being exposed to the stressful ED environment and decreases the pressure on EDs. © Mary Ann Liebert, Inc.

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http://hdl.handle.net/10453/117422