Demographic Profile and Utilization Statistics of a Canadian Inpatient Palliative Care Unit Within a Tertiary Care Setting

Julie Napolskikh, Debbie Selby, Margaret Bennett, Edward Chow, Kristin Harris, Emily Sinclair, Jeff Myers

Abstract


Canadian data describing inpatient palliative care unit (PCU) utilization is scarce. This study performed a quality assessment of a 24-bed short-term PCU with 3 months or less life expectancy policy in a tertiary care setting. Exploration included wait time (WT) for admission, length of stay (LOS), and patient demographics. Methods: a retrospective one-year review of patient records was performed. Results: within the year reviewed, 508 referrals were made, of which 242 resulted in admissions (92% malignant diagnoses), while 266 did not (82% malignant). The most common malignancies in both groups were gastrointestinal, lung, and genitourinary. The median WT for admitted patients was 6 days, varying with referral source, such as the same hospital, home, or another hospital (6, 4, and 8.5 days, respectively). The majority of admissions (93%) occurred in 21 days or less. Patient death (52%), admission to another PCU (25%) and declined offer (10%) were common reasons for no admission. The median LOS of 219 admitted patients was 19 days (0-249). Most patients (94%) died in the PCU, while a minority were discharged. Conclusions: many patients requiring PCU services are admitted within a few days of referral, especially those with the least available support – patients at home. However, half of those who do not receive admission die while waiting – an area for potential improvement. LOS was compliant with the 3-month ‘expected lifespan’ PCU policy. Results are significant as ensuring quality of life for palliative patients includes timely PCU access and sufficient LOS to address symptoms and end-of-life needs.

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DOI: http://dx.doi.org/10.3747/co.v16i1.172






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ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)