Is the use of palliative care services increasing? A comparison of current versus historical palliative care access using health service datasets for patients with cancer

Abstract

Background:

Mature evidence exists supporting the integration of palliative care in cancer care, but translation of evidence into practice is less well understood.

Aim:

We sought to understand current access to palliative care and its timing for people with cancer and to compare practices over time.

Design:

We conducted a retrospective population cohort study using routinely collected administrative health data sets in Victoria, Australia.

Setting/Participants:

All adult cancer decedents in 2018 were identified and clinical, demographic, palliative care access and quality of end of life care indices collected.

Comparisons between a historic cohort of lung, breast and prostate cancer patients who died between the years 2005 and 2009 and those with these diagnoses in the current cohort.

Results:

In 2018 there were 10,245 Victorian decedents with a cancer-coded cause of death, of these 3689 had lung, prostate or breast cancer. In 2018, access to palliative care increased (66% vs 54%) and greater numbers accessed palliative care more than 3 months before death (18% vs 10%) than in 2005–2009. Indices of end of life quality improved across most domains. However the median time between first palliative care and death was shorter in 2018 (22 vs 25 days) and more people first accessed palliative care in the hospitalisation during which they died (43% vs 33%).

Conclusion:

Despite established benefits of early palliative care, the important task of translation of this evidence into practice remains.