Reasons for unplanned hospitalisation in specialist community palliative care: a scoping review

Many individuals receiving specialist community palliative care experience unplanned hospitalisations or emergency department presentations. Understanding the reasons for this is essential to developing person-centred solutions.

To identify the reasons for unplanned hospitalisations among people receiving specialist community palliative care.

A PROSPERO (CRD42024495016) registered scoping review reported according to the PRISMA extension for scoping reviews. A search of CINAHL, PubMed, Embase, and Scopus was undertaken for studies published from 2014 to 2025. Two reviewers completed title, abstract and full text screening and data extraction. Extracted reasons for hospitalisation were inductively coded using a content analysis approach, allowing for a descriptive summary of findings.

Thirteen of the 2482 studies identified met the inclusion criteria. Six categories of hospitalisation reason were generated: (1) unrelieved symptoms (16 subcategories), (2) acute event (five subcategories) (3) signs of deterioration, (4) patient or carer distress/fatigue, (5) misunderstanding of the goals of care and (6) other/unknown. Of the sub-categories, dyspnoea (n = 11 studies, 85%), pain (n = 9, 69%), gastrointestinal symptoms (n = 9, 69%) and infection (n = 7, 54%) were the most frequently reported reasons for hospitalisation. Comparative studies (n = 5) of specialist versus usual or no palliative care showed mixed hospitalisation outcomes, with limited statistical detail.

This scoping review provides insight into patterns of hospitalisation, despite variability in data collection methods. This approach provides a foundation for developing targeted service improvements aimed at supporting individuals to stay at home for more extended periods in the last year of life.