Palliative care services in Australia

The trend data have been expanded to 10 years instead of 5 years in previous reports to provide a more comprehensive picture on the changes during the last 10 years.

Services, patients, episodes of care and phases

Between 2014 and 2023 (Table 1 and Figure 3):

• The number of palliative care services participating in PCOC almost doubled, rising from 101 to 200 services. The increase rates were steeper in 2016, 2019, 2020 and 2023 than other years (11%–19% increases compared with 2%–5% increases). 
• This pattern was broadly consistent with the pattern observed for the number of patients receiving palliative care from the services participating in PCOC – which more than doubled, increasing from 32,800 to 70,100. 
• Meanwhile, the number of palliative care episodes and phases also almost doubled, rising from 44,000 to 90,800 for episodes and rising from 102,000 to 203,600 for phases. The increase in phases was steeper in community settings than in inpatient settings from 2014 to 2023 (8.9% vs 7.1% average annual increase over this period).

Figure 3: Trends in number of palliative care services, patients, episodes of care and phases in services participating in PCOC, 2014 to 2023

Palliative care outcome measures

Of particular interest is whether more patients are achieving positive outcomes. 

Between 2014 and 2023 (Figure 4):

• the proportion of palliative care commencing within 2 days of the patient being ready remained relatively stable (91%–94%; benchmark 1: timely commencement of palliative care) 
• for unstable phases lasting for 3 days or less (benchmark 2): there was a notable increase from 2014 to 2016 (80% to 87%) followed by a stable period between 2017 and 2021 (around 88%). It subsequently dropped slightly in the following 2 years (87% in 2022 and 86% in 2023) 
• outcomes remained relatively stable in those remaining with absent/mild at the end of the palliative care phase for: pain severity (88%–89%; benchmark 3.1), distress from pain (85%–88%; benchmark 3.3), breathing problems (92%–94%; benchmark 3.7) and family/care problems (84%–89%; benchmark 3.9)
• there was an increase in those remaining with absent/mild symptoms at the end of the phase for distress from fatigue (from 73% to 88%; benchmark 3.5)
• there was a notable increase in those moving from moderate/severe to absent/mild symptoms at the end of the phase for: pain severity (from 54% to 62%; benchmark 3.2), distress from pain (from 50% to 58%; benchmark 3.4), distress from fatigue (from 28% to 52%; benchmark 3.6), breathing problems (from 36% to 53%; benchmark 3.8) and family/care problems (from 38% to 53%; benchmark 3.10)
• the score for all 8 case-mix adjusted outcome measures increased (benchmark 4.1–4.8).

Note that comparisons of outcome measures over time should be interpreted with caution, as these outcome measures may be affected by compositional changes in the population. For example, changes in the services participating in PCOC over the same period.

Figure 4: Trends in palliative care outcome results in the services participating in PCOC, 2014–2023