Palliative care outcomes

The Australian Palliative Care Outcomes Collaboration (PCOC), established in 2005, is a national palliative care outcomes and benchmarking program. PCOC’s primary objective is to systematically improve patient outcomes, including pain and symptom control.

The information presented in this section refers to specialist palliative care service data reported to PCOC for the 1 January to 31 December 2019 period. Three levels of PCOC data items are presented here: patient-level, episode-level and phase-level care data. The items in the PCOC data collection:

  • provide clinicians with an approach to systematically assess individual patient experiences
  • include routine Patient Reported Outcomes Measures (PROMs) relating to symptom distress
  • define a common clinical language to allow palliative care providers to communicate with each other
  • facilitate the routine collection of nationally consistent palliative care data for the purpose of reporting and benchmarking to drive improvements in palliative care.

As participation in PCOC is voluntary, the data presented in this section describe a subset of all specialist palliative care services delivered in Australia. In 2019, 148 palliative care services voluntarily participated in PCOC. For further information about PCOC, refer to their website (www.pcoc.org.au).

Data downloads

Palliative care outcomes tables 2019 (192KB XLSX)

Palliative care outcomes section 2019  (449 KB PDF)

The information in this section was last updated in September 2020.

Key points

  • 47,214 patients accessed specialist palliative care services from 148 PCOC participating palliative care providers in 2019.
  • 64,297 episodes of care were provided, of which just over half (32,972) were inpatient episodes.
  • 74.3% of episodes were characterised by a cancer diagnosis.
  • 75.0 was the median age for all patients reported to PCOC during 2019.
  • 92.6% of patients had their care commence on the day of, or the day after, the date they were ready for palliative care (Benchmark 1).
  • 88.3% of patients had urgent needs (i.e. unstable phase) managed in 3 days or less (Benchmark 2).

Inpatient and community care

In 2019, 47,214 patients accessed palliative care from 148 specialist palliative care services participating in PCOC, a 12.0% increase in the number of patients since 2018. There were 64,297 episodes of care reported to PCOC, of which just over half (51.3%) were inpatient episodes. This equates to an average of 1.4 episodes of palliative care per patient.

The information provided on total number of days for episodes of care is categorised by 2 broad types of care—inpatient and community. It should be noted that the number of patients reported to PCOC refers to patients who may receive services both within the inpatient and community settings. Hence, the same patient can have an inpatient episode and then subsequent community episodes and therefore may be counted for both service settings.

Patient characteristics

Age, sex and Indigenous status

The age profile of patients receiving palliative care is shown in Figure PCOC.1. People aged over 65 accounted for over three-quarters of all episodes (76.0%). The age profile of patients in inpatient and community care settings did not differ substantially.

Vertical bar chart showing the per cent of PCOC palliative care episodes by age group and setting. People aged less than 25 accounted for 0.2% of episodes in inpatient settings and 0.5% of episodes in community settings; 25–34, 0.9% and 0.8%; 35–44, 2.1% and 2.0%; 45–54, 6.3% and 6.1%; 55–64, 15.0% and 14.1%; 65–74, 24.4% and 23.9%; 75–84, 27.9% and 29.0%; 85+, 23.3% and 23.6%. Refer to Table PCOC.11.

Source data: Palliative care outcomes tables (192KB XLSX)

The average age for patients across all episodes reported to PCOC during 2019 was 73.5, with a median age of 75.0. Males accounted for 52.7% (33,863) of episodes.

In 2019, 1.6% (712) of PCOC palliative care patients were Aboriginal and Torres Strait Islander People, compared with an estimated 3.3% of the general population in 2016 (ABS 2018a).

Preferred language and country of birth

In 2019, English was reported as the preferred language by 89.6% of PCOC patients. This was followed by Italian (1.9%), Greek (1.5%) and Chinese languages (1.4%). A different distribution of language spoken at home was observed in the 2016 Australian Census (ABS 2017), where 72.7% of people were recorded as speaking English at home, followed by people who mainly spoke Chinese languages (4.0%), Arabic (1.4%) and Vietnamese (1.2%).

The main country of birth of PCOC patients was Australia (63.8%), followed by England (7.0%), Italy (4.0%) and Greece (2.2%).

Diagnosis

In 2019, around 3 in 4 episodes (74.3%) involved a cancer diagnosis—the 3 most frequently recorded diagnoses were lung cancer (15.1%), colorectal (bowel) cancer (7.9%) and other gastro-intestinal cancers (6.9%)—a similar result to that observed in 2017 and 2018.

Socioeconomic status

Compared to the distribution of the Australian population across socioeconomic status groups (i.e. 20% of the population per socioeconomic quintile or level (ABS 2018b)), PCOC episodes were over-represented, proportionally, towards those living in areas classified as having the least socioeconomic disadvantage. In 2019, the highest proportion of episodes, over one quarter (27.6%), was seen for those patients living in areas classified as having the least socioeconomic disadvantage, with this group proportionally over-represented in both inpatient and community settings. People living in areas classified as having the most socioeconomic disadvantage accounted for about 1 in 7 PCOC episodes (14.3%) (Figure PCOC.2).

Socioeconomic status described here uses the Australian Bureau of Statistics Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD) (ABS 2018b).

Vertical bar chart showing the per cent of PCOC palliative care episodes by socioeconomic status (IRSAD quintile), for inpatient and community care settings. Quintile 1 14.0% (inpatient), 14.5% (community); quintile 2 15.7%, 13.8%; quintile 3 21.2%, 21.9%; quintile 4 23.4%, 20.0%; quintile 5 25.6, 29.8. Refer to Table PCOC.6.

Source data: Palliative care outcomes tables (192KB XLSX)

Episode length

The following information refers to closed episodes within the inpatient and community care setting reported to PCOC for 2019. A PCOC episode may be closed because the:

  • setting of palliative care changes
  • principal clinical intent of the care changes and the patient is no longer receiving palliative care
  • patient is formally separated from the service
  • patient dies.

There were 61,702 PCOC episodes which ended in 2019, compared with 46,172 in 2015 (an annual average increase of 7.5%). Inpatient episodes were generally shorter in duration than community episodes. In 2019, about 4 in 5 (80.1%) inpatient episodes lasted between 1 and 14 days (including same-day), whereas around 3 in 5 (62.4%) community episodes were 15 days or longer (Figure PCOC.3).

In 2019, the average length of all episodes (elapsed days) in the inpatient setting was 9.4 days, with a median of 5.0 days. The difference between the average and the median number for inpatient episodes was due to a relatively small set of very long episodes, whereas for Community episodes, the proportion of long episodes was larger (average length 36.6 days, median 21.0 days).

Vertical bar chart showing the per cent of PCOC closed episodes by number of elapsed days, for inpatient and community care settings. 8.9% of inpatient and 3.6% of community setting episodes closed after less than 1 day; 1–2 days, 21.2% and 6.7%; 3–4 days, 15.0% and 5.9%; 5–7 days, 16.1% and 8.3%; 8–14 days, 18.9% and 13.2%; 15–21 days, 8.9% and 9.6%; 22–30 days, 5.4% and 9.1%; 31–60 days, 4.6% and 16.2%; 61–90 days, 0.7% and 8.2%; more than 90 days, 0.3% and 19.2%. Refer to Table PCOC.8.

Source data: Palliative care outcomes tables (192KB XLSX)

Palliative care episodes over time

Between 2015 and 2019 the number of PCOC closed episodes increased for both inpatient (from 25,070 to 32,695) and community palliative care patients (from 21,102 to 29,007) (Figure PCOC.4). This is an average annual increase of 6.9% for inpatient closed episodes and an 8.3% increase for community-based closed episodes over this time period. For further information about palliative care in hospitals, refer to Admitted patient palliative care and other end-of-life care hospital-based facilities.

Horizontal line chart showing the number of closed episodes by palliative care setting from 2015 to 2019. 2015, 25,070 (inpatient) and 21,102 (community); 2016, 26,592 and 20,726; 2017, 28,137 and 22,953; 2018, 28,759 and 24,649; 2019, 32,695 and 29,007. Refer to Table PCOC.7.