Palliative care growing faster

The use of palliative care services in hospitals has been rising at a faster rate than other hospitalisations, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

 

Palliative care aims to improve the quality of life of patients and their families facing a life-ending illness, through the prevention and relief of suffering.

 

The new data, released in the web report “Palliative care services in Australia”, shows that the number of hospitalisations for palliative care rose from about 57,600 in 2011–12 to almost 74,000 in 2015–16—a rise of 28%. Over the same period, the total number of hospitalisations in Australia rose by 15%.

 

‘The hospitalisation rate for palliative care rose across all age groups over this period,’ said AIHW spokesperson Matthew James.

 

‘Although it’s difficult to be definitive about the reasons for this rise, Australia’s growing and ageing population—paired with a rise in chronic and incurable illnesses—has broadened the type of patients requiring palliative care.’

 

In 2015–16, cancer was responsible for about half of palliative care hospital admissions and deaths among palliative care patients.

 

‘Overall, about 157,000 people died in Australia in 2015–16, and almost half were an admitted patient in hospital at the time of their death,’ Mr James said.

 

‘Of these, about half, or 50%, received palliative care services, up from 39% in 2011–12’.

 

The report also shows that in 2016–17, about 15,000 patients were subsidised by Medicare for their visit to a physician specialising in palliative care.

 

‘At the core of palliative care is the aim to provide relief from pain and other distressing symptoms, and medications can be central to this,’ Mr James said.

 

‘MBS-subsidised palliative medicine specialist services increased by 26% between 2012–13 and 2016–17 and spending on these services increased by 31%, compared to a 19% increase in all Medicare spending for the period’, Mr James said.

 

Palliative care in residential aged care

The Australian Government subsidises residential aged care services for older Australians whose care needs are such that they can no longer remain in their own homes. Residential aged care services provide accommodation and services to people who require ongoing health and nursing care due to chronic impairments and a reduced degree of independence in activities of daily living. They provide nursing, supervision or other types of personal care required by the residents.

 

Key points from the report:

  • There were about 239,600 permanent residents in Australia in 2016–17 with completed ACFI appraisals, and about 1 in 50 of these residents (4,509) had an ACFI appraisal indicating the need for palliative care.
  • The proportion of ACFI appraisals indicating palliative care within aged care facilities increases with the age of the resident.
  • The population rate of appraised need for palliative care among permanent residents was highest in Inner regional areas (33.6 per 100,000 population) followed by Outer regional (16.9) and Major cities (15.4).
  • Around 3 in 10 (29.4%) of permanent residents with an appraised need for palliative care had been diagnosed with cancer. The types of cancer most often recorded were Lung cancer (19.1%) and Colorectal (bowel) cancer (14.2%).

 

The report also outlined that:

  • Residential aged care services face particular difficulties in administering palliative care, because permanent residents often have dementia and/or communication difficulties and complex care needs (AIHW 2018). In addition, there is a high burden of chronic disease and comorbidity in the residential aged care population (Hillen, Vitry & Caughey 2017).
  • Palliative care provided in a residential aged care service is regulated under the Aged Care Act 1997, within the Quality of Care Principles. Under the schedule of specified care and services, an Approved Provider is responsible for providing access to a qualified practitioner from a palliative care team, and the establishment of a palliative care program including monitoring and managing any side effects for any resident that needs it. In addition, under Schedule 2 – Accreditation Standards, an Approved Provider is responsible for ensuring the comfort and dignity of terminally ill care recipients is maintained.
  • In practice, it is possible to receive palliative care in residential aged care without having received an ACFI assessment indicating the need for palliative care.

 

17 October 2018.