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Is It Feasible and Desirable to Collect Voluntarily Quality and Outcome Data Nationally in Palliative Oncology Care?

David C. Currow, Kathy Eagar, Samar Aoun, Dave Fildes, Patsy Yates, Linda J. Kristjanson

From the Department of Palliative and Supportive Services, Flinders University, Adelaide; Centre for Health Service Development, University of Wollongong, Wollongong; Western Australian Centre for Cancer and Palliative Care, Curtin University of Technology, Perth; and Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia

Corresponding author: David Currow, MD, Flinders University, 700 Goodwood Rd, Daw Park, South Australia 5041, Australia; e-mail: david.currow{at}rgh.sa.gov.au

Hospice/palliative care is a critical component of cancer care. In Australia, more than 85% of people referred to specialized hospice/palliative care services (SHPCS) have a primary diagnosis of cancer, and 60% of people who die from cancer will be referred to SHPCS. The Palliative Care Outcomes Collaboration (PCOC) is an Australian initiative that allows SHPCS to collect nationally agreed-upon measures to better understand quality, safety, and outcomes of care. This article describes data (October 2006 through September 2007) from the first 22 SHPCS, with more than 100 inpatient admissions annually. Data include phase of illness, place of discharge, and, at each transition in place of care, the person's functional status, dependency, and symptom scores. Data are available for 5,395 people for 6,379 admissions. After categorizing by phase of illness and dependency, there remain at the end of each admission 12-fold differences (mean, 26%; range, 4% to 52%) in the percentage of patients who became stable after an unstable phase; seven-fold differences (mean, 22%; range, 6% to 41%) in the percentage of patients with improved symptom scores, five-fold differences (mean, 25%; range, 12% to 64%) in discharge back to the community, four-fold differences (mean, 10%; range, 4% to 16%) in improved function, and three-fold differences in the length of stay (mean, 14 days; range, 6 to 19 days). PCOC shows it is feasible to collect quality national palliative care outcome data voluntarily. Variations in outcomes justify continued enrollment of services. Benchmarking should include all patients whose cancer will cause death and explore observed variations.

Supported by the Palliative Care Branch of the Population Health Division of the Australian Government's Department of Health and Ageing (funding for the Australian Palliative Care Outcomes Collaboration).

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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