Overview of patients, episodes of care and phases
PCOC defines a patient as a person for whom a palliative care service accepts responsibility for assessment and/or treatment as evidenced by the existence of a medical record.
In 2024, among the 72,400 patients receiving palliative care from the 202 services participating in PCOC:
- 3 in 5 (61%) had a diagnosis of cancer (Figure 1)
- 1 in 2 (50%) died – of these 70% died in hospital, 17% at home, and 12% in residential aged care.
Of the 35,900 patients that died in 2024, the median number of days from referral to death was 6 days, with referrals on average occurring much earlier for patients in community than inpatient settings (20 compared with 4.0 days). Earlier referrals were also observed for people with malignant compared with non-malignant diagnosis in both inpatient (median of 6 vs 2 days) and community settings (27 and 14 days, respectively).
For further details on the characteristics of these patients, see Tables 1-3, 11 in Data tables: PCSiA 2025 Palliative care outcomes.
A palliative care episode is a period of contact between a patient and a service provider where palliative care is provided in a single setting (inpatient or community setting).
A patient may have multiple palliative care episodes over the reference period if a patient’s care needs change, they no longer require palliative care, or they change settings. For example, if a patient receives care at home and then transitions to care in a hospital, this would be reflected as 2 separate episodes.
Palliative care episodes, as used in this report, include both open episodes (those without an episode end date in the reporting period), and closed episodes (those with an episode end date in the reporting period), unless otherwise specified.
In 2024, there were 95,500 palliative care episodes recorded in PCOC, equating to an average of 1.3 palliative care episodes per patient.
Among these palliative care episodes:
- the median age at episode start was 77 years
- 55% of referrals were from public hospitals, including 17% from medical team and 10% from palliative care oncology team. A further, 10% of referrals were from private hospitals (over half of which (5.7%) were from palliative care or oncology team), and 15% from general practitioners and community palliative care services (7.4% and 7.8%, respectively) (Figure 1).
There were 85,600 episodes that ended (closed palliative care episodes) in 2024. Among these closed palliative care episodes (Figure 1 and Table 7):
- 3 in 4 (75%) ended within 30 days, with most ending within 2 weeks (60%).
- Inpatient episodes were generally shorter than community episodes, with a median duration (elapsed days) of 4 days compared to 23 days. This is driven by inpatient episodes 3 times as likely as community episodes to end within 2 days (35% and 10%, respectively).
- Over 1 in 2 (54%) inpatient episodes ended with the patient dying compared to 26% for community episodes. The most common reason for community episodes ending was the patient being admitted into inpatient care, accounting for 1 in 2 (52%) episodes.
There are four palliative care phase levels included in PCOC:
- stable phase: patient problems and symptoms are adequately controlled by an established plan of care
- unstable phase: an urgent change in the plan of care or emergency treatment is required
- deteriorating phase: the care plan is addressing anticipated needs but requires periodic review
- terminal phase: death is likely within days.
Note that palliative care phases are not necessarily sequential. A patient may transition back and forth between phases; therefore, it is likely that a patient will have more than one phase within an episode.
See Data source.
In 2024, there were 211,000 palliative care phases recorded in PCOC – 104,500 in inpatient settings and 106,500 in community settings. On average, patients had 2.4 phases per closed episode (2.2 for inpatient settings and 2.5 for community settings), and 2.9 phases per patient (Table 1).
Among these palliative care phases:
- 2 in 5 (42%) were deteriorating phases, almost 1 in 3 (32%) were stable phases, followed by terminal (15%) and unstable (11%), with the proportion of deteriorating or terminal phases higher in inpatient settings (62%) than community settings (53%) (Figure 1).
- Overall, the average length of phase was 3 times as long in community than inpatient settings (11.1 days compared to 3.6 days, respectively), especially for stable phases (23 compared to 5.7 days) and deteriorating phases (15 compared to 4.7 days, respectively).
- Patients in an unstable palliative care phase were more likely to rate their symptoms (using symptom assessment scale (SAS)) as moderate or severe at phase start than patients in any other phase. In contrast, patients in stable or terminal phases were more likely to report absent/mild symptoms at phase start (Table 10 and Figure 1).
Figure 1: Overview of patients, episodes of care and phases in services participating in PCOC, 2024
This dashboard presents diagnoses of patients, referral source and length of episodes and types of phases in services participating in PCOC in 2024.
