Background Palliative care is medical care that focuses on relieving symptoms, improving quality of life, and assisting with decision-making through Advanced care planning(ACP). An individual ACP reflects value and preference of each patient. Patients with an advanced disease usually refer to a super tertiary hospital for diagnosis and advanced treatment before referring back to primary care. The challenge for palliative care team is advance care planning at the first admission with limited time.

Methods This retrospective article retrieved data from all hospitalized non-ICU patients who were treated under Karunruk Palliative Care Center in Srinagarind Hospital, Khon Kaen University, Thailand between 1 October 2021 to 30 September 2022. Descriptive data were presented with frequency and percentage. Association factors with home death preference were analyzed by univariate and multivariate logistic regression.

Results A total 819 inpatients data were collected, 450(54.95) male, age <60 285(34.80%), age 60–70 266(32.48%), age >70 268(32.73%), married 566(69.11%), single 67(8.18%), other marital status 186(22.71%), no co-morbidity 454(55.43%), 1–2 co-morbidities 290(35.41%), >2 co-morbidities 75(9.16%), cancer 608(74.24%) and non-cancer 211(25.76%). Palliative performance scores for cancer patients were 10–30% 132(21.71%) 40–60% 415(68.26%) and 70–90% 61(10.03%). Most family and/or patients (801/819, 97.80%) participated ACP discussion in the first consultation session; 727/801(90.76%) chose full comfort ACP and 623/801(77.78%) preferred home death. Multiple logistic regression found married, others marital status, cancer and full comfort ACP had odd ratio 0.76, 2.63, 2.98, 2.80 and 4.36 respectively. 95%CI were 1.49–4.65, 1.55–5.74, 1.83–4.29, 2.61–7.30 and p-value = 0.001, 0.001, <0.001 and <0.001 respectively.

Conclusion In the first palliative consultation session, ACP can be conducted and got impressively high full comfort ACP and home death preference. Factor associated with home death are married, others marital status, cancer and full comfort ACP.