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Rural Health Centers
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Updated: Jul 2, 2025

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Palliative Approach Remains Lacking in Terminal Hospital Admissions for Chronic Disease Across Rural Settings:

Rebecca Disler1, Amy Pascoe2, Xinye Esther Chen3

  • 1Respiratory Research@Alfred, Department of Immunology and Pathology (R.D., A.Y.P., N.S.), Central Clinical School, Monash University, Melbourne, Australia; Department of Rural Health (R.D., E.L., H.H., J.W., S.S., K.G.), The University of Melbourne, Shepparton, VIC, Australia.

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Palliative care and end-of-life planning were infrequently documented for patients with chronic diseases in rural hospitals. Targeted strategies are needed to improve care for these high-needs rural populations.

Keywords:
Chronic diseasePalliative careRural

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Area of Science:

  • Gerontology
  • Public Health
  • Palliative Care

Background:

  • Palliative care significantly benefits patients with end-stage chronic diseases.
  • Access to palliative care is often limited, particularly in rural areas.
  • Understanding palliative care provision for rural populations with chronic disease is crucial.

Purpose of the Study:

  • To assess the provision of a palliative approach for patients with chronic diseases during their terminal hospital admission.
  • To identify gaps in end-of-life care for rural populations with chronic conditions.

Main Methods:

  • A multisite, retrospective medical record audit was conducted.
  • The study included decedents with primary diagnoses of chronic lung, heart, or renal failure, or multimorbidity.
  • Data were collected for admissions occurring in 2019.

Main Results:

  • Of 241 decedents, palliative service referral and input were low (30.7% and 20.3% respectively).
  • Advance care planning (29.5%), preferred place of death (7.9%), and spiritual support (7.5%) were rarely documented.
  • Hospital site and diagnosis significantly influenced outpatient care and palliative approach.

Conclusions:

  • End-of-life planning and specialist palliative care involvement were infrequent for rural chronic disease patients.
  • There is a need for targeted strategies to enhance palliative care for prevalent, high-needs rural populations.
  • Improving access to and documentation of palliative care is essential for rural end-of-life care.