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.