Palliative care-related hospitalisations are those episodes of admitted patient care where palliative care was a component of the care provided during all or part of an episode of admitted patient care. These hospitalisations can be divided into 2 groups depending on how they are identified in the data:
Note that the use of the term “other end-of-life care” refers to the broader palliative care definition and is not limited to end-of-life care (generally defined as people who are likely to die within the next 12 months).
In 2020–21, among the 90,700 palliative care-related hospitalisations in public and private hospitals:
- 50,000 were for palliative care and 40,700 for other end-of-life care, equating to 19.5 and 15.9 per 10,000 population, respectively
- males accounted for more than half (53%) and the average age at admission was 74 years old
- 2 in 5 (42%) had a principal diagnosis of cancer
- 1 in 2 hospitalisations (53%) ended with the patient dying in hospital – 65% for palliative care hospitalisations and 40% for other end-of-life care hospitalisations
- average length of stay was almost twice as long as for all overnight hospitalisations (hospitalisations that exclude same-day stays) – 10 days (9.2 days for palliative care and 11.1 days for other end-of-life care) compared with 5.3 days for all hospitalisations.
Between 2015–16 and 2020–21, there was a 23% increase in the number of palliative care-related hospitalisations – this increase was at a steeper rate than for all hospitalisations (12% increase) over the same period.
For more information, including the impact of COVID-19, refer to Hospitals – Admitted patient care and specialised facilities for palliative care section.
Medicare-subsidised specialist services
Medicare Benefits Schedule (MBS)-subsidised palliative specialist services in this report only relate to palliative medicine attendances/consultations and case conferences that are both provided by palliative medicine physician/specialist and are claimed under specialist palliative care MBS item numbers. Note that palliative care physicians/specialists may at times use other MBS items when attending to palliative care patients and other health professionals also attend to terminally ill patients and provide palliative care. These items are not included in the data on this page, as they are not claimed specifically as a palliative care-related service under the MBS.
In 2021–22, among the 14,500 people who received 69,100 palliative medicine attendance and case conference services:
- 3 in 4 (77%) were provided to people aged 65 and over, including 23% for those aged 85 years and over
- an average of 4.8 services per provided per person annually
- 4 in 5 (81%) services were for palliative care attendances in consulting rooms or a hospital, 6.3% (4,300) were for attendances in other settings (such as a person’s place of residence) and 13% (8,900) were for case conferences (community case conference and discharge case conference)
- $5.6 million was paid in benefits for these services, at an average of $390 per person.
Between 2012–13 and 2018–19, the number of people receiving palliative medicine attendances/consultations increased by 35%, and remained relatively stable in the following 2 years (2018–19 and 2019–20) before declining by 13% in the 12 months to 2021–22. This was a steeper annual decline than that for people receiving all specialist attendances (0.8% decline). While for palliative medicine case conferences, the number of people receiving these services has doubled between 2012–13 and 2021–22.
For more information, including the impact of COVID-19, refer to Medicare-subsidised palliative medicine attendance and case conference services section.
Palliative care-related prescriptions are an important component of care for palliative patients. One of the attributes of palliative care is to ‘provide relief from pain and other distressing symptoms’ (WHO 2020). Palliative care-related prescriptions are defined as those listed in the Palliative Care Schedule of the Pharmaceutical Benefits Scheme (PBS) (see Technical information). This schedule aims to improve access to essential and affordable medications for patients receiving palliative care.
In 2021–22, there were 1.3 million palliative care-related prescriptions provided to 453,300 people. Of these:
- 1 million prescriptions were for pain relief, accounting for 79% of all palliative care-related prescriptions
- 9 in 10 (89%) palliative care-related prescriptions were prescribed by general practitioners.
Between 2017–18 and 2021–22, the number of people dispensed with palliative care-related prescriptions declined by 18% overall, with the annual rate of decline steeper in 2021–22 than in 2018–19 (12% compared with 3.7%, respectively). However, the number of palliative care-related prescriptions has remained relatively stable over this period, leading to increases in the number of prescriptions per person from 2.1 to 2.8 over this period.
For more information, including the impact of COVID-19, refer to Palliative care-related medications section.
Residential aged care
The Australian Government subsidises residential aged care services for older Australians whose care needs are such that they can no longer remain living in their own homes. The data used here are based on Aged Care Funding Instrument (ACFI) appraisals, which are used to determine Australian Government subsidies for people living in permanent residential aged care (PRAC) services. There is limited data on the need for and receipt of palliative care among people accessing home-based and residential aged care services. Available data is based on those in permanent residential aged care appraised as requiring end-of-life palliative care and for whom a claim was submitted.
In 2021–22, among the 4,800 people appraised as requiring palliative care in PRAC (2.0% of all people):
- 3 in 5 (59%) were aged 85 years and over
- 1 in 5 (21%) had cancer listed as the first condition on their appraisal, compared with 3.7% for those not appraised as requiring palliative care
- 1 in 2 (50%) exited from PRAC within 8 weeks of admission, compared with 7.9% for those not appraised as requiring palliative care.
For more information, including the impact of COVID-19, refer to Palliative care for people living in residential aged care section.
Key measures of quality care are the outcomes that patients, their families and carers achieve. The Australian Palliative Care Outcomes Collaboration (PCOC) is a national program that aims to systematically improve patient and carer outcomes, using standardised validated clinical assessment tools (clinician and patient-rated scales) to benchmark and measure outcomes. These include timelines of palliative care, responsiveness to urgent needs, and responsiveness and appropriateness of the care plan in place.
In 2021, among the 58,700 patients that received palliative care from the 177 palliative care services participating in PCOC:
- 2 in 3 (66%) patients had a diagnosis of cancer
- 3 in 4 (77%) palliative care closed episodes ended within 30 days, with most ending within 2 weeks (62%)
- 9 in 10 (88%) unstable phases (urgent needs) were resolved within 3 days or less
- 9 in 10 palliative care phases that started with absent/mild patient pain remained absent/mild at the end of the phase.
Achieving an absent/mild symptom outcome is less likely when the patient has moderate/severe symptoms to begin with, especially for those with distress from fatigue and breathing problems:
- 3 in 5 palliative care phases that began with moderate/severe patient pain reduced to absent/mild by the end of the phase
- 1 in 2 of those starting with moderate/severe distress from fatigue or breathing problems reduced to absent/mild by the end of the palliative care phase.
Between 2017 and 2021, there was a 36% increase in the number of services participating in PCOC, with the rate of increase in services slowing in the 12 months to 2021.
For more information, including the impact of COVID-19, refer to Palliative care outcomes section.
The palliative care workforce is made up of a broad range of professional groups, including specialist palliative medicine physicians, palliative care nurses, general practitioners, pharmacists, allied health professionals, other medical specialists (such as oncologists and geriatricians), as well as other health workers, support staff and volunteers. Each of these play a unique role in supporting people with a life limiting illness to receive comprehensive, patient-centred care. However, existing national data sources only capture information on physicians with a primary specialty of palliative medicine (palliative medicine physicians) and nurses working in palliative care (palliative care nurses).
In 2020, among the 300 palliative medicine physicians and 3,800 palliative care nurses employed in Australia:
- women accounted for 2 in 3 (64%) employed palliative medicine physicians and 9 in 10 (92%) employed palliative care nurses
- most worked in Major cities – 4 in 5 (84%) of employed palliative medicine physicians and 3 in 4 (72%) employed palliative care nurses
- most worked in a hospital setting – 3 in 4 (75%) of employed palliative medicine physicians and half (56%) of all employed palliative care nurses.
Between 2016 and 2020, there was a 29% increase in the number of employed palliative medicine physicians and a 9.5% increase in palliative care nurses.
For more information, including the impact of COVID-19, refer to Palliative care workforce section.
Where do I go for more information?
For more information on palliative care services see: