Early Admission to Community-Based Palliative Care Reduces Use of Emergency Departments in the Ninety Days before Death

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, t...

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Main Authors: McNamara, Beverley, Rosenwax, Lorna, Murray, Kevin, Currow, D.
Format: Journal Article
Published: Mary Ann Liebert, Inc Publishers 2013
Online Access:http://hdl.handle.net/20.500.11937/23098
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author McNamara, Beverley
Rosenwax, Lorna
Murray, Kevin
Currow, D.
author_facet McNamara, Beverley
Rosenwax, Lorna
Murray, Kevin
Currow, D.
author_sort McNamara, Beverley
building Curtin Institutional Repository
collection Online Access
description 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.
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spelling curtin-20.500.11937-230982017-09-13T13:56:21Z Early Admission to Community-Based Palliative Care Reduces Use of Emergency Departments in the Ninety Days before Death McNamara, Beverley Rosenwax, Lorna Murray, Kevin Currow, D. 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. 2013 Journal Article http://hdl.handle.net/20.500.11937/23098 10.1089/jpm.2012.0403 Mary Ann Liebert, Inc Publishers restricted
spellingShingle McNamara, Beverley
Rosenwax, Lorna
Murray, Kevin
Currow, D.
Early Admission to Community-Based Palliative Care Reduces Use of Emergency Departments in the Ninety Days before Death
title Early Admission to Community-Based Palliative Care Reduces Use of Emergency Departments in the Ninety Days before Death
title_full Early Admission to Community-Based Palliative Care Reduces Use of Emergency Departments in the Ninety Days before Death
title_fullStr Early Admission to Community-Based Palliative Care Reduces Use of Emergency Departments in the Ninety Days before Death
title_full_unstemmed Early Admission to Community-Based Palliative Care Reduces Use of Emergency Departments in the Ninety Days before Death
title_short Early Admission to Community-Based Palliative Care Reduces Use of Emergency Departments in the Ninety Days before Death
title_sort early admission to community-based palliative care reduces use of emergency departments in the ninety days before death
url http://hdl.handle.net/20.500.11937/23098