Measure 1.2
- Objective area
- Effective
- Outcome area
- Psychosocial wellbeing
- Measure
- Proportion of palliative care phases for people with life-limiting illnesses for which psychological or spiritual problems improved or remained at a low level after intervention.
- Population
- People who received a service from a palliative care service provider participating in the Palliative Care Outcomes Collaboration (PCOC).
- Numerator
- Number of palliative care phases ending within the reference period with a valid Palliative Care Problem Severity Score (PCPSS) for ‘Psychological/Spiritual’ problems at phase start and end and for which the PCPSS improved or remained absent/mild.
- Denominator
- Number of palliative care phases ending within the reference year with a valid PCPSS for ‘Psychological/ Spiritual’ problems at start and end of phase.
- Computation
- (Numerator ÷ Denominator) x 100
- Disaggregation
- Age group, Sex, Socioeconomic area, Remoteness area, Diagnosis, Setting, Phase type, Problem severity at phase start. See Data sources for more information on these items.
- Source
- Palliative Care Outcomes Collaboration (PCOC) data collection.
- Definitions
- Palliative Care Problem Severity Score (PCPSS) – a clinician rated screening tool to assess the overall severity of problems within four key palliative care domains including the patient’s psychological or spiritual wellbeing. The scores are 0 – absent, 1 – mild, 2 – moderate and 3 – severe (Masso et al. 2016).
- Table 1.2.2 shows a symptom is considered to have improved over the phase if there was at least a one-point change between phase start and end. A symptom is considered to have remained at a low level if the symptom at phase start was between 0 and 1 and did not increase.
Table 1.2.2: PCPSS improvement in measure 1.2 numerator Severity at phase start Score at phase start Score at phase end Absent 0 0 Mild 1 ≤ 1 Moderate 2 ≤ 1 Severe 3 ≤ 2 - Notes
- There is currently no complete national data on patient outcomes for the psychological or spiritual distress of people with life-limiting illnesses. However, part of the picture is available from the PCOC data collection. Participation in PCOC is voluntary and contribution to the collection is sought from all palliative care service providers in public and private health sectors, across all regions, and across inpatient and community settings. Not all services participate in PCOC and so the data used for this measure only includes a subset of all palliative care delivered in Australia. Most services participating in PCOC are specialist palliative care services. See Data sources for more information.
- State and territory disaggregation has not been included for this measure. Further work is required to better understand the coverage of the PCOC data collection across different jurisdictions.
- All phases without a valid start and end PCPSS for ‘Psychological/ Spiritual’ problems were excluded. PCPSS assessments are not performed at death. Most terminal phases end in death.
- In 2022, 95.2% of phases had a valid PCPSS for ‘Psychological/ Spiritual’ problems at phase start and 68.5% at phase end. Altogether 66.5% had valid PCPSS for ‘Psychological/Spiritual’ problems at phase start and end. The most common reason for missing PCPSS ‘Psychological/ Spiritual’ at phase end were death, followed by case closure/discharge to another setting.
- In 2022, 84% of terminal phases ended in death and only 13.2% of phases had valid PCPSS for ‘Psychological/Spiritual’ problems at phase start and end.
Masso M, Allingham SF, Johnson CE, Pidgeon T, Yates P, Currow D, Eagar K. Palliative Care Problem Severity Score: Reliability and acceptability in a national study. Palliat Med. 2016 May;30(5):479-85. doi:10.1177/0269216315613904.