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135 A tale of two settings: are there differences in hospice inpatient initial needs & outcomes depending on where the patient is admitted from?
  1. FA Malik,
  2. S Clarke and
  3. D Barclay
  1. St. Wilfrid’s Hospice, Eastbourne, East Sussex NHS Healthcare Trust


Introduction Understanding patient needs and assessing outcomes are important to improve quality of care. As part of an ongoing evaluation of hospice inpatient (IPU) bed use, the needs & outcomes of those admitted to the IPU from the local hospital trust and from community settings were compared to examine if there were differences depending on settings admitted from.

Methods Cross-sectional retrospective analysis of consecutive IPU admissions from the local hospital NHS Trust (HA) and admissions from the community (CA) to a specialist palliative 14-bedded hospice from August 16–March 17. Data items collected include patient demographics & outcome data e.g. IPU admission IPOS, phase of illness (PoI) & AKPS. All data anonymised. Results analyzed and descriptive statistics utilized.

Results 50 HA and 113 CA admissions during the time period (in addition 24 respite admissions and 6 'out of area' HA not used in analysis). There were no differences in mean age (HA 71.3 yrs, CA 71 yrs) or gender (HA 60%, CA 53% male) and no difference in malignant diagnosis between groups (HA 82%, CA 88%).

IPU admission mean AKPS was worse in HA (33) than CA (44.6) (p<0.005) but no difference in mean IPOS (HA 31.2, CA 34, p=0.1).

HA patients were more likely to be in the 'dying phase' (PoI) on IPU admission (14/50,28%) compared to other phases than CA patients (9/110,8%) (p<0.001). Mean IPU length of stay was longer in CA (17.6 days) compared to HA (13.2 days) (p=0.05). HA were more likely to die during that IPU admission compared to CA patients (46/50 (92%) vs 69/110 (62%)), (p<0.05). 41/110 CA patients were discharged from IPU.

Conclusions Findings highlight potential differences in patient needs and outcomes depending on which setting the patient was admitted from. This will influence development of 24/7 services & bed utilization. Further analysis is beneficial to clarify findings.

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