Duration and determinants of hospice-based specialist palliative care: A national retrospective cohort study:

Background:Understanding service provision for patients with advanced disease is a research priority, with a need to identify barriers that limit widespread integration of palliative care.Aim:To identify patient and organisational factors that influence the duration of hospice-based palliative care in the United Kingdom prior to death.Design:This is a retrospective cohort study.Setting/participants:A total of 64 UK hospices providing specialist palliative care inpatient beds and community services extracted data for all adult decedents (aged over 17 years) with progressive, advanced disease, with a prior referral (e.g. inpatient, community teams, and outpatient) who died between 1 January 2015 and 31 December 2015. Data were requested for factors relating to both the patient and hospice site.Results:Across 42,758 decedents, the median time from referral to death was 48 days. Significant differences in referral to death days were found for those with cancer (53 days) and non-cancer (27 days) (p < 0.0001). ...