The new research from Swansea University could ameliorate care for dying patients across Wales.
Experts studied data from almost 270,000 people who died of non-sudden causes between 2014 and 2023. They tracked where patients spent their final year: at home, in hospital or in care facilities, and analysed how having palliative care registration affected their experience.
Researchers found most people spend the majority of their final year at home. However, emergency hospital visits become increasingly common as death approaches. In fact, over 90% of emergency hospital admissions came directly from individuals’ homes.
According to the research, patients registered with palliative care services were 23% more likely to be admitted to hospital from home, but they spent less time there once admitted. What’s more, these people were discharged faster, with an average stay almost two days shorter.
However, patients in care homes with nursing showed an opposite pattern. Those registered for palliative care had 17% to 18% fewer emergency admissions compared to those without such registration and were discharged quicker once admitted.
The researchers said: ‘These patterns suggest that palliative care registration is associated with more effective management of patients’.
Although, the study found just 28% of people approaching death were registered for palliative care services. Men, residents of deprived areas and people living alone were significantly underrepresented on the palliative care register, potentially widening health inequalities.
Against this backdrop, rural and urban differences also became apparent within the research. Urban residents had higher rates of emergency hospital admissions and were less likely to be discharged home from hospital, whereas rural patients were more likely to return home.
With these findings in mind, the study recommends that health and care services should prioritise identifying people who need palliative care earlier and provider better support for those dying at home.
‘This work enabaling a system-wide evaluation for the entire of population of Wales was only made possible by linkage of anonymous health and administrative data facilitated by the SAIL Databank,’ Professor Rhiannon Owen from Swansea University’s Faculty of Medicine, Health and Life Science, said. ‘ Our findings provide a vital evidence-based foundation to support ministerial policy for designing more efficient, compassionate, and equitable end-of-life care in Wales.’
The full research can be read here.
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