Who receives specialist palliative care in Western Australia - and who misses out

Rosenwax, Lorna; McNamara, Beverley

doi:10.1191/0269216306pm1146oa

Cited by 97 publications

(114 citation statements)

References 67 publications

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“…We found that patients who had a PC referral were more often married than were patients without a PC referral, which has also been reported in other studies [17,20,25,26]. The reason for this observation is unknown, but it may be possible that a spouse acts as an advocate, lending a second voice to issues of symptom management at the end of life.…”

Section: Discussionsupporting

confidence: 64%

“…We only identified a few studies that explored population databases [17,18] and surveyed families of cancer patients [19,20], although they did not assess PC referral patterns from an institutional perspective. Our institution is a National Cancer Institute designated comprehensive cancer center and includes an active PC program consisting of three mobile teams, an acute PC unit, and a supportive care clinic.…”

Section: Introductionmentioning

confidence: 99%

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Access to Palliative Care Among Patients Treated at a Comprehensive Cancer Center

et al. 2012

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Background. Palliative care (PC) is a critical component of comprehensive cancer care. Previous studies on PC access have mostly examined the timing of PC referral. The proportion of patients who actually receive PC is unclear. We determined the proportion of cancer patients who received PC at our comprehensive cancer center and the predictors of PC referral.Methods. We reviewed the charts of consecutive patients with advanced cancer from the Houston region seen at MD Anderson Cancer Center who died between September 2009 and February 2010. We compared patients who received PC services with those who did not receive PC services before death.Results. In total, 366 of 816 (45%) decedents had a PC consultation. The median interval between PC consultation and death was 1.4 months (interquartile range, 0.5-4.2

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Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Access to Palliative Care Among Patients Treated at a Comprehensive Cancer Center

et al. 2012

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“…7,8 This is much lower than statistics from other countries. The prevalence of hospice utilization has been reported as 65% in the United States, 9 19% (inpatient hospice) to 68% (hospice home care) in the United Kingdom, 10 65%-68% in Australia, 11,12 and 67% in Hong Kong. 13 In order to increase the utilization rate of hospice care in Taiwan, a new hospice consulting system with combined hospice care for cancer patients was recently propagated.…”

Section: Discussionmentioning

confidence: 99%

Impact of Combined Hospice Care on Terminal Cancer Patients

Loke

Rau

Huang

2011

Journal of Palliative Medicine

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Background: Many patients with advanced cancer will develop physical and psychological symptoms related to their disease. These symptoms are infrequently treated by conventional care. Palliative care programs have been developed to fill this gap in care. However, there are limited beds in hospice units. To allow more terminal cancer patients to receive care from a hospice team, a combined hospice care system was recently developed in Taiwan. This study is a report of our experiences with this system. Patients and Methods: From January to December 2009, terminal cancer patients who accepted consultation from a hospice team for combined hospice care were enrolled in the study. Demographic data, clinical symptoms, referring department, type of cancer, and outcome were analyzed. Results: A total of 354 terminal cancer patients in acute wards were referred to a hospice consulting team. The mean patient age was 61 years, and the proportion of males was 63.28%. After combined hospice care, there was a significant improvement in the sign rate of do-not-resuscitate (DNR) orders from 41.53% to 71.47% ( p < 0.0001), and awareness of disease prognosis from 46.05% to 57.69% ( p ¼ 0.0006). Combined hospice care also enabled 64.21% of terminal cancer patients who were not transferred to hospice ward to receive combined care by a hospice consulting team while in acute wards, thus increasing the hospice utilization of terminal cancer patients. The major symptoms presented by the patients were pain (58%), dyspnea (52%), constipation (45%), and fatigue (23%). Conclusions: Through the hospice consulting system, hospice combined care has a positive effect on the utilization of hospice care, rate of DNR signing and quality of end-of-life care for terminal cancer patients.

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“…However, that study did not provide an estimate of the proportion of HCC patients who receive palliative care. In a retrospective cohort study of cancer patients using linked data from Western Australia, Rosenwax and McNamara (2006) found that, between 1 July 2000 and 31 December 2002, 68% of cancer patients received specialist palliative care in the last 12 months of life. This proportion is used in the present study.…”

Section: Economic Burden: Unit Costs Of Managing Patients With Chronimentioning

confidence: 99%

A survey of Sydney general practitioners' management of patients with chronic hepatitis B

Najjar

Gupta

Pritchard-Jones

et al. 2016

Medical Journal of Australia

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Objective: To examine the chronic hepatitis B (CHB) assessment and management practices of general practitioners in the Sydney and South Western Sydney Local Health Districts, areas with a high prevalence of CHB, and to obtain their views on alternative models of care. Design, setting and participants: We used a descriptive, cross‐sectional study design to survey GPs who had seen at least one patient aged 18 years or over who had been notified as having CHB to the Public Health Unit between 1 June 2012 and 31 May 2013. There were 213 eligible GPs; the response rate was 57.7%. Main outcome measures: The CHB assessment, management and referral practices of the GPs, and their opinions about different models of care. Results: Most GPs (78.9%) were at least reasonably confident about managing CHB. GPs were generally most comfortable with a model of care that involved initial referral to a specialist; managing CHB without specialist input or with only review by a specialised nurse practitioner were less popular. Conclusion: These results suggest that barriers, including dependence on specialist input, still hinder the appropriate assessment and management of CHB patients by GPs. Well designed and targeted support programs that include specialist support are needed if there is to be a successful shift to an increased role for GPs in the model of care for managing CHB.

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Who receives specialist palliative care in Western Australia - and who misses out

Cited by 97 publications

References 67 publications

Access to Palliative Care Among Patients Treated at a Comprehensive Cancer Center

Access to Palliative Care Among Patients Treated at a Comprehensive Cancer Center

Impact of Combined Hospice Care on Terminal Cancer Patients

A survey of Sydney general practitioners' management of patients with chronic hepatitis B

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