Inpatient hospice admissions trend reversal: clinical audit

Objectives To evaluate admission reasons, referral sources, and patient outcomes among hospice inpatients, and to explore factors contributing to a reduced average length of stay observed locally. Methods A retrospective audit of all hospice inpatient admissions between September and December 2024 was undertaken. Data included referral source, diagnosis, reason for admission, length of stay and outcomes. Findings were compared with previous local and national data. A re-audit in March 2025 assessed whether trends persisted. Results A total of 130 patients were admitted during the initial audit period. Most referrals (74%) originated from the hospital, with 30% from the emergency department; 75% of this subgroup died within 72 hours. Overall, 54% of patients had non-malignant conditions. Among hospital referrals, non-malignant diagnoses were predominant (70%), while among community referrals, most (93%) had cancer. The average length of stay was 4.7 days, markedly shorter than the national average of 1–2 weeks. During admission, 82% of patients died, and 18% were discharged. The reaudit confirmed the persistence of these trends. Conclusion Hospice inpatient care is shifting towards hospital referrals, non-malignant diagnoses and shorter stays. Models of care must adapt to support patients with unpredictable disease trajectories and crisis admissions.