Demographic profile and utilization statistics of a Canadian inpatient palliative care unit within a tertiary care setting

BACKGROUND: Canadian data describing inpatient palliative care unit (pcu) utilization are scarce. In the present study, we performed a quality assessment of a 24-bed short-term pcu with a 3-months-or-less life expectancy policy in a tertiary care setting. METHODS: Using a retrospective chart review, we explored wait time (wt) for admission (May 2005 to April 2006), length of stay [los (February 2005 to January 2006)], and patient demographics. RESULTS: The wt data showed 508 referrals, with 242 resulting in admissions (92% malignant diagnoses) and 266 not (82% malignant). The most common malignancies in both groups were gastrointestinal, lung, and genitourinary. Median wt for admitted patients was 6 days, varying with referral source, such as the same hospital, home, or another hospital (6, 4, and 8.5 days respectively). Most admissions (93%) occurred in 21 or fewer days. Patient death (52%), admission to another pcu (25%), and declined offer (10%) were common reasons for no admission. Median los for 219 admitted patients was 19 days (range: 0–249 days). Most patients (94%) died in the pcu; a minority were discharged. CONCLUSIONS: Many patients requiring pcu services are admitted within a few days of referral, especially patients with the least available support: those at home. However, half of the non-admitted patients die while waiting—a potential area for improvement. The los for admitted patients complied with the 3-month “expected lifespan” pcu policy. Results are significant, because ensuring quality of life for palliative care patients includes timely pcu access and sufficient los to address end-of-life needs.