Prevalence and predictors of transition to a palliative care approach among hospital inpatients in England

Abstract

Aim: The aim of this research was to quantify the extent of palliative care transitions among patients in two acute hospitals and to identify factors predicting the initiation of a transition to palliative care.

Methods: We conducted a prospective survey of hospital inpatients in two hospitals in the United Kingdom in which we examined hospital case notes for evidence of palliative care need. Further data were collected from medical staff, nursing staff, patients, and proxy consultees.

Results: Of 514 participating patients, 183 (36.2 percent) fulfilled criteria for palliative care need. In 61 cases (33 percent), there was evidence of transition to a palliative care approach. There was an increased likelihood of palliative care transition among patients with cancer, dementia, or stroke.

Conclusions: There is a need for discussion of the meaning, and operationalization, of palliative care transitions if UK policy to increase the extent of transitions is to be enacted. This study has implications internationally, given the increased global focus on the role of the acute hospital in palliative care.