National palliative care measures

This measure is about understanding whether people with life-limiting illnesses are receiving treatments that could potentially undermine quality of life at the end of their lives. It is important to note that the data used for this measure do not capture the nuance at the time of treatment such as the intentions of care, the patient’s functional status, or patient/family preferences. Further, it can be difficult for treating clinicians to accurately predict life expectancy, in particular, knowing that it might be the person’s last 30 days of life. Given these uncertainties, this measure is likely to include some treatments that were in fact appropriate at the time of treatment.

Note, data for this measure are not available for Western Australia and Northern Territory. This means the counts presented here underestimate national totals and the influence on proportions is unknown.

The desired outcome is that people with life-limiting illnesses who receive potentially non-beneficial treatments at the end of life is low, meaning the measure will decrease.

Objective area: Safe    Outcome area: Avoidance of overtreatment

Trends

In 2018, among people with life-limiting illnesses whose death was registered in New South Wales, Victoria, Queensland, South Australia, Tasmania, or the Australian Capital Territory, 8.9% received at least one potentially non-beneficial treatment at the end of their life. This increased to 9.6% in 2019 before decreasing to 8.3% in 2020 (Figure 2.1.1).

Figure 2.1.1: Proportion of people with life-limiting illnesses who received potentially non-beneficial treatments at the end of life, 2018-2020.

Characteristics

Figure 2.1.2 highlights that the proportion of people with life-limiting illnesses who received at least one potentially non-beneficial treatment at the end of life, and whose death was registered in New South Wales, Victoria, Queensland, South Australia, Tasmania, or the Australian Capital Territory in 2020, varied by these characteristics:

• The lowest proportion was in South Australia, where 5.9% of people with life-limiting illnesses received a potentially non-beneficial treatment at the end of life. Differences between states and territories should be interpreted with caution as modes of service delivery, definitions, and data recording practices differ across states and territories.
• There was little difference in the proportion between Australians from all Regional and Remote areas (combined) (8.4%) and Australians from Major Cities (8.2%).
  Note: Western Australia and Northern Territory are not included in these data so disaggregation by remoteness area should be interpreted with caution (for more information see Data sources).
• A higher proportion of males (9.6%) received a potentially non-beneficial treatment at the end of life when compared with females (6.9%).
• The proportion decreased as age increased – 25.2% of children (0–14 years) and 28.1% of those aged 15–24 received a potentially non-beneficial treatment at the end of life, compared with 3.0% of people aged 85 and over.
• The proportion increased with increasing disadvantage – 6.5% of people who lived in the highest socioeconomic areas received a potentially non-beneficial treatment at the end of life, compared with 9.5% of people living in the lowest socioeconomic areas.
• The proportion varied considerably by cause of death – the highest proportion was among people with liver diseases (20.0%) and the lowest proportion was for people with dementia/ Alzheimer’s disease/ senility (1.2%).

Figure 2.1.2: Proportion of people with life-limiting illnesses who received potentially non-beneficial treatments at the end of life, by selected characteristics, 2020