To understand the epidemiology and complexity of patients receiving community palliative care from Silverchain in Western Sydney and determine predictors of key outcomes to inform service delivery.

Silverchain introduced a specialist community palliative care service in the Western Sydney Local Health in 2017. The area is home to one million people with high levels of cultural diversity and faces a growing burden of disease and rising demand for health services. 

Data was extracted electronically for patients receiving care within 2017 to 2022.  Variables include patient demographics, diagnosis, symptoms, service provision, PCOC variables, and outcomes. In addition, manual data extraction was used to extract information on comorbidities, frailty, and current patient medications on admission to the palliative care service on a random sample (n=480) of patients.  Descriptive statistics were derived using standard statistical methods, trends in characteristics overtime and predictors of key outcomes (e.g. death in preferred place) were derived using multivariable regression models. 

Patients demonstrated high complexity with 79% diagnosed with cancer and 21% another life-limiting illness. Patient characteristics on admission included high levels of comorbid conditions (e.g hypertension 41%, diabetes 26%, cardiac arrhythmia 22%, chronic pulmonary disease 21%, ischaemic heart disease 19%), a median of 6 current medications (range 0-23) and high prevalence of frailty (43%).  Additionally, 49% were pensioners, 16% required an interpreter and 36% stated English was a second language. Results from the full analysis will be presented, including predictive modelling.