The following lists palliative care research primarily conducted by Australian research groups. The list is based on application of the CareSearch search filter for palliative care to identify articles held within the PubMed database and corresponding to the strongest evidence. Articles have been selected based on relevance and new articles are added on a weekly basis.
Whilst not an exhaustive list, the aim is to keep the community informed by providing a snapshot of recent research findings and planned studies in the Australian setting.
Bourne OP, Fischer A, Good P.
Objectives: This study aimed to determine the frequency and characteristics of patients discharged from a specialist community palliative care service, and the incidence, timing and reasons for discharge.
Methods: This retrospective audit reviewed admissions and discharges over a 6-year period, including demographics, length of admission, discharge reason and readmission status.
Results: Of the 5149 admissions, 17% were discharged and 22% were later readmitted. 19% of readmissions were again discharged. The main reason for discharge was having no specialist palliative care needs (53%), followed by patients moving out of the service catchment area (13%). Median length of stay before discharge was 141 days, and median time from discharge to readmission was 214 days.A small group of 32 patients was referred, reviewed and immediately discharged, and most had a non-malignant diagnosis and were male. The main reasons for immediate discharge was the absence of palliative care needs or the service not being needed or wanted. A third of these patients were later readmitted.
Conclusion: These data show that a substantial proportion of community specialist palliative care service patients are discharged. It raises further research questions around flexible models of care, validated discharge criteria and implementing quality measures on discharge.
Clapham S, Daveson B, Ayalew AA, Draper K, Hartati A, Reed K, et al.
Purpose: Palliative care is delivered across most healthcare settings, yet service capability remains poorly defined, limiting quality improvement. A clearer definition is essential to drive system-wide improvement. This scoping review was undertaken to answer two important questions: What are the key constructs that define palliative care service capability, and how can they inform quality improvement and benchmarking?
Methods: A scoping review, retrieving studies from Medline, PsycINFO, and CINAHL. This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Relevant literature published in English from the year 2000 onwards, focusing on palliative care service delivery, standards, quality, and outcomes were included. Data were organised using an evidence map to define service capability and develop a conceptual framework.
Results: Palliative care service capability is defined as the ability of a service to deliver care, shaped by the broader health system and organisation in which the service operates. Four core domains emerged as central to the concept and were mapped against existing standards, quality indicators and clinical frameworks: (1) assessment, planning, and care provision; (2) transitioning patients between services; (3) availability of care; and (4) collaboration and linkages across health services involved in delivering palliative care.
Conclusion: This review provides a definition and conceptual model for palliative care service capability to support quality assessment and facilitate meaningful benchmarking. Integrating this framework into national quality initiatives may help identify gaps in service and system delivery, standardise care processes, and enhance patient-centred outcomes.
Elvidge N, Carter HE, Rolfe M, Smith K, Phillips JL.
Context: Many individuals receiving specialist community palliative care experience unplanned hospitalisations or emergency department presentations. Understanding the reasons for this is essential to developing person-centred solutions.
Objectives: To identify the reasons for unplanned hospitalisations among people receiving specialist community palliative care.
Methods: A PROSPERO (CRD42024495016) registered scoping review reported according to the PRISMA extension for scoping reviews. A search of CINAHL, PubMed, Embase, and Scopus was undertaken for studies published from 2014 to 2025. Two reviewers completed title, abstract and full text screening and data extraction. Extracted reasons for hospitalisation were inductively coded using a content analysis approach, allowing for a descriptive summary of findings.
Results: Thirteen of the 2482 studies identified met the inclusion criteria. Six categories of hospitalisation reason were generated: (1) unrelieved symptoms (16 subcategories), (2) acute event (five subcategories) (3) signs of deterioration, (4) patient or carer distress/fatigue, (5) misunderstanding of the goals of care and (6) other/unknown. Of the sub-categories, dyspnoea (n = 11 studies, 85%), pain (n = 9, 69%), gastrointestinal symptoms (n = 9, 69%) and infection (n = 7, 54%) were the most frequently reported reasons for hospitalisation. Comparative studies (n = 5) of specialist versus usual or no palliative care showed mixed hospitalisation outcomes, with limited statistical detail.
Conclusion: This scoping review provides insight into patterns of hospitalisation, despite variability in data collection methods. This approach provides a foundation for developing targeted service improvements aimed at supporting individuals to stay at home for more extended periods in the last year of life.
Hutchison A, Spooner A, Parker D, Yates P.
Background: Internationally, the ageing population is driving increased demand for palliative care across primary, aged, and healthcare sectors. Quality indicators for palliative care have been extensively researched, with systematic reviews synthesising these indicators for older populations across various care settings.
Aim: To identify a comprehensive set of quality indicators for palliative care for older people.
Design: A research protocol was developed following Joanna Briggs Institute's umbrella review methodology and registered with PROSPERO. Included reviews were assessed using the Joanna Briggs Institute's Critical Appraisal Instrument for Systematic Reviews and Research Synthesis. Identified quality indicators were mapped to Donabedian's quality model (structure, process, outcome) and aligned with the Australian Commission on Safety and Quality's essential elements for safe, high-quality end-of-life care.
Data sources: MEDLINE, CINAHL, EMBASE, Scopus, and Cochrane were searched from January 2000 to May 2025.
Results: A total of 1272 records were identified, after removing duplicates 719 were screened by title and for eligibility. Four articles met the criteria, yielding 1071 quality indicators, of which 658 were unique. Among these, 402 (61%) related to the process of care, 179 (27%) to care outcomes, and 77 (12%) to structure.
Conclusion: This review highlights a critical gap in quality indicators related to structure, including the physical and organisational settings of healthcare delivery. Indicators often emphasised a biomedical approach, overlooking the psychological, social, cultural, and spiritual aspects essential to high-quality palliative care. Further work is needed to develop a comprehensive, practical set of quality indicators that can be used across care settings.
Kahawita T, Fischer A, Webb L, Good P.
Backgound: With an ageing population, there is an increasing demand for home-based palliative care to improve end-of-life care. Funding models can impact service utilisation and patient outcomes.
Aims: To compare two funding models to assess the effects on service utilisation, hospital admission, home death rates and concordance between preferred and actual place of death.
Methods: A single-centre, prospective cohort study compared the first 12 months of two funding models. Eligible patients accessing a private health insurance-funded palliative care programme were included. Each funding model had different eligibility criteria: the capitation model (May 2020-April 2021) required a ≤3-month prognosis and preference for home death, while the fee-for-service model (December 2022-November 2023) had a ≤6-month prognosis with no preference.
Results: The capitation cohort had fewer hospital admissions (27% vs. 64%) in the last 4 weeks of life, and a higher rate in home or a residential aged care facility (78% vs. 31%). Concordance with preferred place of death was similar across cohorts (91% vs. 76%). Except for assistants in nursing, the fee-for-service cohort accessed more services, with utilisation increasing near death. In the final 4 weeks, the capitation cohort had higher service use (median 14 vs. 7) and more involvement of assistants in nursing (40% vs. 5%) and medical practitioners (60% vs. 35%).
Conclusions: This is one of the first studies to look into funding models and how funding mechanisms influence service utilisation, intensity and timing. While trends emerged, cohort differences led to variability and limited interpretation.
Last updated 30 April 2024