Hospice home care halves hospital deaths

Categories: Research.

The report by the Irish Hospice Foundation (IHF) estimates that the percentage of all deaths taking place in hospitals is around 43%, but that hospice home care reduces this to 21%. It further found that while, on average, 26% of people die at home each year, this figure rises to 40% of all patients who are cared for by hospice home care teams.

Inequalities

Through comparing different parts of the country, the report shows how unequal availability of hospice services impacts greatly on where people die. The report also highlights how certain areas of the country have no dedicated hospice beds at all and claims that, due to regional inequity in resource allocation, an estimated 2,500 patients are denied admission to hospice beds every year.

Sharon Foley, CEO of The Irish Hospice Foundation said: “In some areas of the country, patients at their most vulnerable are being denied access to services simply because of where they live. Not having access to inpatient hospice beds has a critical impact on whether a patient dies in an acute hospital or not.”

Cost savings

The report also shows how significant savings can be achieved when patients have access to comprehensive hospice inpatient and home care services, with greatly reduced admissions and lengths of stay in expensive acute hospital care.

Dr Kathy McLoughlin, who worked on the report, said: “Many international studies indicate savings when patients access hospice programmes. They also show improved length of life, better symptom control and patient and carer experience. Hospice services can provide real savings to the healthcare system and meet the needs of patients. By ensuring that patients with life-limiting conditions are cared for in the most appropriate setting for their needs such as hospices, the State can secure the more efficient use of acute hospital resources.”

Future need

An aging population and increasing incidence of cancer and other long-term conditions means that the need for palliative care in Ireland is only going to increase.

By 2016, over 12,500 people dying annually in Ireland from both cancer and non-cancer conditions would benefit from specialist palliative care. Also, while the majority of people who die each year will not require specialist palliative care, professionals in the field have a vital role to play in advising and educating healthcare staff providing generalist palliative care in the community. This need too will continue to grow.

The Irish Hospice Foundation is calling on the Irish government to explore what might be achievable through a broad end of life strategy.

Sharon Foley said: “It is clear that the 2001 national policy on palliative care and the related 2009 framework – both valid policy tools – need to be updated to address new challenges and ways to deliver healthcare. We believe that by managing national health resources more effectively, many more people could be facilitated to be cared for and to die outside of acute hospitals and in their preferred place of care. It is essential that we safeguard what developments in hospice care have been achieved. Hospice home care, which is available all over the country and which is shown to be highly effective, must be protected. For each of us, there’s only one chance in life for a good death – that’s one chance to get end of life care right.”

Access to specialist palliative care services and place of death in Ireland – what the data tells us‘ is the second paper in the IHF’s Perspectives Series. The series of discussion documents aim to stimulate thought and debate about specialist palliative care services in Ireland. The aim of this report is to provide data, analysis and commentary to stimulate discussion on emerging trends in relation to the provision of specialist palliative care in Ireland.

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