National palliative care measures

People with life-limiting illnesses – all people who died in the reference year and had an underlying cause of death amenable to palliative care based on Murtagh et al. (2013) ) as shown in Table 2.1.2.

Potentially non-beneficial treatment – A treatment or intervention that is unlikely to prolong life or provide comfort at the end of life including the following treatments from the Australian Classification of Health Interventions Code:

Table 2.1.3: Non-beneficial treatment by Australian Classification of Health Intervention Codes

1. Identifying overtreatment using administrative data is challenging as the data do not capture the nuance at the time of treating, such as treatment appropriateness, care intent, life expectancy, patient functionality, patient and family preferences, and physician-patient interactions. Furthermore, end of life trajectories are inherently uncertain. It can be very difficult for clinicians to predict time to death, and they may not know that a treatment is non-beneficial at the time of treating. Given the uncertainty of the circumstances at the time of treating and the social and ethical pressures that exist, a certain level of potentially non-beneficial treatments will likely always be present but reducing their occurrence should be an aim of improving the quality of palliative care in Australia.
2. There is currently no complete national data on receipt of potentially non-beneficial treatments for people with life-limiting illnesses. The NIHSI linked data asset is the only available national data that identifies inpatient procedures and cause-specific outcomes. However, this data collection does not present a complete picture of health service use, as it excludes hospital data from Western Australia and the Northern Territory, and all private hospitals nationally for this analysis, for the reference period. It omits services received by patients in specialised palliative care units in private hospitals/ facilities. For more information see Data sources.