Dying patients who received community-based palliative care visited the emergency department half as much in their last year of life, according to an Australian study.
The study was published Feb. 3 in Annals of Emergency Medicine. Researchers examined nearly 12,000 decedents who died with neoplasms, heart failure, renal failure, chronic obstructive pulmonary disease or liver failure in Western Australia in 2009 to 2010.
The study found the average rate of ED visits for the cohort decreased 50 percent when receiving community-based palliative care. For decedents aged 60 years and younger, the relative reduction in ED visits was 43 percent, compared to 71 percent for people aged 90 years and older, researchers said.
Additionally, decedents living in the most disadvantaged areas had a 44 percent reduction in ED visits when receiving community-based palliative care, according to the study. This compared with a 60 percent reduction for decedents who lived in the least disadvantaged areas. Researchers said the ED visit rates while patients were receiving palliative care also varied by ED visit history, partner status and where the patient lived.
"It is encouraging that palliative care was associated with reduced emergency department visits for five different diseases [and] isn't limited to just cancer or heart failure, for example," said study lead Lorna Rosenwax, PhD, of Curtin University in Perth, Australia. "Most patients who were in their last year of life visited the emergency department at least once, with one person visiting 74 times in the space of a year. Only about one-third (32 percent) of the patients we studied received community-based palliative care but they were much less likely to require emergency medical treatment as a result."
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