Third of hospital inpatients die within one year, Scottish study confirms

A team led by Professor David Clark and Dr Chris Isles found that on one day in April 2013, 30% of all people in hospital in Scotland had died one year later.

Of 10,595 inpatients in hospital that day, 3,126 had died within 12 months.

This is a follow-up to an earlier study, published in Palliative Medicine in 2014, which showed the imminence of death among a national cohort of hospital inpatients.

Partly funded by Marie Curie Scotland, the studies are designed to fill a gap in evidence on the proportion of the hospital population that is in the last year of life, helping to provide information for policy-makers and hospital managers to help them orient their services to the needs of this group of inpatients.

“Our original study, published in 2014, has been very widely cited and used by clinicians and planners. Now we can be confident that the result was not a ‘fluke’. We now know with confidence that almost one third of people in hospital in Scotland at any given time are in the last year of their lives,” said Professor Clark.

“The results of the original study have been widely used in advocacy and planning. They highlight that end of life care is part of the core business of so-called ‘acute’ hospitals. The results present great opportunities for identification, care planning and the delivery of palliative care to people in the last year of life.

“The purpose of the follow up was to check whether the findings of our original study, based on data from a single day in 2010, were reliable.  Back then we found that 29% of hospital inpatients on a single day had died within a one year follow up period.”

For this follow-up, the team used rigorous methods to build on the original study. “We repeated the original method, chose a ‘census date’ close to the first one, but for 2013 – three years on from the first study.  We are now planning a second follow-up based on a census date in April of this year.”

There are hopes for further uses of this study methodology outside Scotland. “We are keen to see the study replicated elsewhere and work is well underway in both Denmark and New Zealand to that end,” explained Professor Clark.

The findings have been published in a letter to the Journal of Pain and Symptom Management, which is open access.

This article first appeared on the UK edition of ehospice.