National palliative care measures

Predictable death – all causes of death excluding sudden deaths where the underlying cause of death:

• occurs during pregnancy, childbirth, or the puerperium (ICD-10-AM O00-O99)
• originates during the perinatal period (ICD-10-AM P00-P96)
• results from injury, poisoning and certain other external causes (ICD-10-AM S00-T98)
• or results from external causes of morbidity and mortality (V01-Y98) (Rosenwax et al. 2005).

Specialist palliative care services – are comprised of multidisciplinary teams with specialised skills, competencies, experience, and training to deliver care to people where the palliative needs are complex and persistent. This includes:

• inpatient hospital care where palliative care was a component of the care provided during all or part of the episode. Includes care type of palliative care, or diagnosis of palliative care (Z51.5) for care type other than palliative care.
• out-patient hospital clinic services for palliative care medical consultation, usually delivered by a palliative medicine specialist or medical practitioner providing palliative care (outpatient clinic type tier 2: 20.13).
• Medicare-subsidised consultations with palliative medicine specialist/physician (all MBS services where the service provider code is ‘043’ or ‘077’).

1. Not all people with life-limiting illnesses require specialist palliative care. A sustainable, quality, and accessible palliative care system is one that is integrated into primary health care, community, and home-based care, as well as supportive of informal carers such as family and community volunteers.
2. The Rosenwax (2005) definition of the 'Maximal Estimate' of a potential palliative care population was used to identify people who died from a 'predictable death'. 
3. There is currently no complete national data on receipt of specialist palliative care. The NIHSI linked data asset is the only available national data that identifies services across settings and cause-specific outcomes. However, this data collection does not present a complete picture of health service use, as it excludes hospital data from Western Australia and the Northern Territory, and all private hospitals nationally for this analysis. It omits services received by patients in specialised palliative care units in private hospitals/facilities. Further, the scope of the data asset does not include all settings in which specialist palliative care services may be delivered, such as in community health settings or by allied health professionals (for example, care provided in the home, or by ambulance, disability, or aged care services) that are not captured through Medicare-subsidised claim items. See Data sources for more information.