Background Non-malignant disease accounts for approximately 3 in 4 deaths in England and Wales (Office for National Statistics, 2021) yet hospice care continues to be skewed in favour of supporting people with malignant disease (Hospice UK, 2021). The Health Select Committee report (2004) identified a lack of palliative care provision for people with non-malignant disease as a major inequity, with fewer than 10% of hospice beds being devoted to non-malignant disease. Different disease trajectories and patient/carer expectations were identified as perceived barriers to increasing this proportion.
Griffin and Conway (2008. Int J Palliat Nurs. 14:616) compared non-malignant and malignant admissions to a Scottish hospice between 2003 and 2006 found no significant difference between length of stay, reason for admission and outcome. Despite this, malignant disease continues to be over-represented in hospice referrals and admissions for end-of-life care (Tobin, Rogers, Winterburn, et al., 2021. BMJ Support Palliat Care.). Despite the audit published by Griffin and Conway (2008) suggesting there is no difference in length of stay, our recent experience has led us to question whether this is the case in our hospice.
Aim(s) The primary aim is to compare in-patient admissions for malignant and non-malignant disease, focusing on a) length of inpatient stay, b) primary reason for admission, and c) outcome of admission. The secondary aim is to identify causes of discharge delays, and whether this differs between malignant and non-malignant disease.
Methods A retrospective audit from April 2022, of the most recent 30 consecutive patients in each disease group (malignant vs non-malignant primary diagnosis) to the in-patient unit of a hospice in England. Primary diagnosis defined as the life-limiting condition which demanded the most resources during the patient’s stay. Data collected from electronic hospice records.
Results We hope that our anticipated results will provide insight into whether these groups differ in their admission lengths and outcomes to help us understand some of the challenges of providing in-patient palliative care in non-malignant disease.
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