Community specialist palliative care service discharges: clinical characteristics

This study aimed to determine the frequency and characteristics of patients discharged from a specialist community palliative care service, and the incidence, timing and reasons for discharge.

This retrospective audit reviewed admissions and discharges over a 6-year period, including demographics, length of admission, discharge reason and readmission status.

Of the 5149 admissions, 17% were discharged and 22% were later readmitted. 19% of readmissions were again discharged. The main reason for discharge was having no specialist palliative care needs (53%), followed by patients moving out of the service catchment area (13%). Median length of stay before discharge was 141 days, and median time from discharge to readmission was 214 days.A small group of 32 patients was referred, reviewed and immediately discharged, and most had a non-malignant diagnosis and were male. The main reasons for immediate discharge was the absence of palliative care needs or the service not being needed or wanted. A third of these patients were later readmitted.

These data show that a substantial proportion of community specialist palliative care service patients are discharged. It raises further research questions around flexible models of care, validated discharge criteria and implementing quality measures on discharge.