Background: Accessibility and quality of hospital-based palliative care in Thailand have received scant attention. Objective: To determine the prevalence of inpatients who require in-hospital palliative care, to identify the proportion with access to specialist palliative care, and to define the factors associated with accessibility to specialist palliative care. Design: A cross-sectional analysis of a multicenter survey. Setting/Subjects: We surveyed all hospitalized patients from Thailand's four regions admitted to 14 tertiary care hospitals. Measurements: We used the Supportive and Palliative Care Indicators Tool to identify palliative care patients then reviewed their medical records. We categorized hospitalized palliative care patients into a palliative care consultation group and a nonconsultation group. The odds ratio (OR) between patient characteristics and patient groups was estimated using binary logistic regression. Results: One-fifth (18.7%) of hospitalized patients were palliative care patients, whereas only 17.3% received a specialist palliative care consult. Of these, one-third (28.4%) received advance care planning (ACP) documentation. One-quarter of patients in pain were not prescribed analgesics. The logistic regression analysis revealed that palliative care consultations were associated with patients >65 years (OR = 1.830, 95% confidence interval [CI]:

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Health (MOH) is boosting palliative care in the community to enable more people to demise in their PPOD. A 2014 Lien Foundation survey on death attitudes found that over three-fourths of Singaporeans prefer home death, yet only a quarter of deaths in 2020 occurred at home. In comparison, Singapore Hospice Council (SHC) found that 55% of patients referred to PHC were able to die at home. This retrospective study aims to determine the rates of Advance Care Planning (ACP) discussion in a homecare setting, its associated rates of fulfilled PPOD, and possible reasons for unfulfilled PPOD. Methods De-identified data of 402 patients from Dover Park Hospice (DPH) homecare who demised between January and December 2022 were reviewed. 12 patients were excluded due to inconclusive data. Data of 390 patients were analysed for completed ACP discussion initiated by the homecare team, and the fulfilment of PPOD.Results ACP was initiated by the homecare team for 373 (95.6%) of 390 patients. Only 2 (0.5%) patients declined or were not ready, while the remaining 15 (3.9%) demised before the initial home visit. PPOD was fulfilled for 344 (92.2%) patients, of which 249 (72.4%) patients managed to demise at home. Conclusions Majority of patients receiving PHC have ACP discussions, which may be attributed to consistent interactions and rapport between patients and the homecare team. The rates of fulfilled PPOD home deaths are higher than the national average (72.4% vs 55%), which suggests homecare patients and families referred to PHC are well-supported at the end-of-life. Hence, building the capacity to provide PHC service in the community may improve fulfilled PPOD rates.