Little is known about what happens to patients after discharge from the community palliative care service.

 

To describe the outcomes of patients discharged alive from the community palliative care service, including survival, post-discharge ambulance callouts, emergency department (ED) visits, hospitalisations, and place of death.

 

Patients discharged alive from the Sacred Heart Community Palliative Care Service in Sydney between 1 July 2010-30 September 2018 were identified using local health records. The outcomes of these patients were tracked utilising data linkage by the Centre for Health Record Linkage, which included data from NSW ambulance, NSW emergency department data collection, NSW admitted patient data collection and the Registry of Birth, Deaths and Marriages. The study was censored on 31 December 2018.

The median age of the 1095 people (575F, 520M) who were discharged alive was 77 (IQR 65,87) years. The median follow-up duration was 259 (IQR 90, 658) days. About three-quarters(n=791) of the patients died by the censor date, with a median survival of 163 (IQR 58, 393) days after discharge. 296 deaths (37%) occurred in the hospital. 

 

365 (33%) patients did not require ambulance callouts, ED, or hospital visits. Their median follow-up time was 160 days (IQR 27,533). 563 (51%), 577 (53%) and 665 (61%) patients had an ambulance callout, ED visit or hospital admission, respectively. Among them, the median annual rate of ambulance callouts was 2.54 (IQR 1.05 – 5.21); 2.41 (IQR 1.18, 5.05) for ED presentations and 3.85 (IQR 1.82, 8.47) for hospitalisation. 

 

111 (10.1%), 131 (12%) and 213 (19.5%) patients had an ambulance callout, ED, or hospital admission within 30 days of discharge from the community palliative care service, respectively.

Most patients did require an ambulance, ED, or hospital admission after discharge from the service, with a large proportion dying outside the hospital.