Palliative care outcome measures
The Australian Palliative Care Outcomes Collaboration (PCOC) is a national program that uses standardised validated clinical assessment tools to benchmark and measure palliative care outcomes. The development and implementation of these outcome measures and associated benchmarks helps improve patient and carer outcomes and drives improvements in the quality of palliative care.
In 2024, the 95,500 palliative care episodes and 211,000 palliative care phases recorded in PCOC revealed:
- In over 9 in 10 (92%) episodes, care commenced within 2 days of the patient being ready for palliative care – 97% in inpatient settings and 87% in community settings.
- Almost 9 in 10 (86%) unstable phases lasted for 3 days or less – 90% in inpatient setting and 81% in community settings.
- Almost 9 in 10 palliative care phases that began with absent/mild symptoms remained in that range by the end of the phase – 88–89% for pain severity, distress related to pain, fatigue, and family/carer problems. For distress related to breathing problems a higher proportion remained in the absent/mild phase (94%).
- When symptoms started as moderate/severe, improvement to absent/mild at phase end was less frequent, especially for fatigue (50%), breathing problems (52%), and family/carer problems (54%).
Case-mix adjusted outcomes measure the changes in symptoms relative to the national average. It allows services to compare the changes in symptoms and problem scores for ‘like’ patients (patients in the same phase who started with the same level of symptoms).
In 2024, the data on 95,500 palliative care episodes and 211,000 palliative care phases recorded in PCOC revealed the following key findings on palliative care outcomes (Figure 2):
- In over 9 in 10 (92%) episodes, care commenced within 2 days of the patient being ready for palliative care – 97% in inpatient settings and 87% in community settings.
- Almost 9 in 10 (86%) unstable phases lasted for 3 days or less – 90% in inpatient setting and 81% in community settings.
- Almost 9 in 10 palliative care phases that began with absent/mild symptoms remained in that range by the end of the phase – 88–89% for pain severity, distress related to pain, fatigue, and family/carer problems. For distress related to breathing problems a higher proportion remained in the absent/mild phase (94%).
- When symptoms started as moderate/severe, improvement to absent/mild at phase end was less frequent, especially for fatigue (50%), breathing problems (52%), and family/carer problems (54%).
Case-mix adjusted outcomes measure the changes in symptoms relative to the national average. It allows services to compare the changes in symptoms and problem scores for ‘like’ patients (patients in the same phase who started with the same level of symptoms).
Case-mix adjusted outcomes is calculated by measuring the mean change in symptoms on both Palliative Care Problem Severity Score (PCPSS) and PCOC Symptom Assessment Scale (PCOC SAS), after adjusting for both phase and the symptom score at the start of each phase.
The PCOC palliative care case-mix adjusted outcome measures include eight symptoms/problems:
- Four clinical reported problem severity using PCPSS, including pain, other symptoms, family/care problems and psychological/spiritual problems.
- Four patient reported symptom distress using PCOC SAS, including pain, nausea, breathing problems and bowel problems.
A case-mix adjusted score is calculated by comparing the change in symptoms/problems to patients at baseline national average level (January to June 2014). A positive score indicates that a service is performing above the baseline national average, and a negative score indicates that it is below the baseline national average.
A full description on each of case-mix adjusted outcome measures and benchmarks reported is included in Data source.
In 2024 (Figure 2):
- On average, services in all settings (inpatient and community settings combined) and in inpatient settings were performing above the baseline national average on all 8 case-mix adjusted outcome measures.
- In community settings, most services performed above the national baseline, with only two case-mix adjusted outcome measures (clinician-reported pain severity and patient-reported distress from pain), falling below the average.
Figure 2: Palliative care outcome results in the services participating in PCOC, 2024
This dashboard presents results and benchmarks of palliative care outcomes and case-mix adjusted outcomes in services participating in PCOC in 2024.
