Empowering end-of-life choices: evaluation of an innovative model of integrated palliative care

BACKGROUND: Recognising patients' preferences for end-of-life care and enabling people to die in their preferred location is critical to effective palliative care delivery. AIM: To evaluate patients' end-of-life choices for death and consumer satisfaction with support provided. METHODS: This single-centre, prospective, cohort study included patients that accessed a private health insurance funded community palliative care programme. FINDINGS: Over 5 years (August 1, 2016 to July 31, 2021) of the 779 patients admitted to the community specialist palliative care service, 608 died. Among those who died, 39.5% died at home, 40.1% in an in-patient palliative care unit and 20.4% elsewhere. Overall, 85.7% achieved their preferred place of death, with high rates of adherence across different settings: 79.0% for home, 91.5% for in-patient palliative care unit and 100% for acute in-patient setting. Satisfaction with services was high. CONCLUSIONS: Key components to achieving a high preferred place of death include enhanced in-home support, case-managed community specialist palliative care and dedicated access to multidisciplinary team members.