End of life services are provided across the health and human services sector by public and private hospitals, general practitioners, disability services and in residential and community based settings1.

The significance of the end of life care has been highlighted in a series of recent policy statements and government reports, particularly:

  • Caring for Older Australians: Productivity Commission Inquiry Report (2011)1
  • The 2012 Senate Inquiry into Palliative Care2 and;
  • A National Health and Hospitals Network for Australia’s Future: Delivering better health and better hospital3.

However, evidence shows there are critical gaps in end of life service provision in Australia and internationally, including high rates of pain and other symptoms that negatively impact quality of life4-6, insufficient measures to limit aggressive care7, problems with referral to palliative care services8-11 and professional resistance to share care with palliative care services12.

The social and economic implications of these gaps contributed to the establishment of the 2012 Senate Inquiry into Palliative Care in Australia2. The Inquiry recommended several major reforms to end of life service provision, noting the urgency for reform given Australia’s ageing population. The Inquiry also recommended that collaborative research frameworks were needed in Australia to provide the evidence base needed to address these issues.

References

  1. Australian Government Department of Health and Ageing. Supporting Australians to Live Well at the End of Life: National Palliative Care Strategy Barton: Commonwealth Department of Health and Ageing. 2010.
  2. Committee SCAR. Palliative Care in Australia: Commonwealth of Australia;2012.
  3. Productivity Commission. Caring for Older Australian Draft Report. Canberra: Australian Government; 2011.
  4. Government A. A National Health and Hospitals Network for Australia’s Future – Delivery better health and better hospitals.
  5. Committee SCAR. Palliative Care in Australia: Commonwealth of Australia;2012.
  6. The SUPPORT Principal Investigators. A controlled trial to improve care for seriously ill hospitalized patients: the study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). November 1995;247(20):1591-1598.
  7. Desbiens NA, Wu AW, Broste SK, et al. Pain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. Crit Care Med. December 1996;24(12):1953-1961.
  8. Somogyi-Zalud E, Zhong Z, Lynn J, Hamel MB. Elderly persons’ last six months of life: findings from the Hospitalized Elderly Longitudinal Project. J Am Geriatr Soc. 2000;48(5 Suppl):S131-S139.
  9. Higginson I, Webb D, Lessof L. Reducing hospital beds for patients with advanced cancer. 1994;344(8919):409.
  10. Burge F, Johnston G, Lawson B, Dewar R, Cummings I. Population-based trends in referral of the elderly to a comprehensive palliative care programme. Palliat Med. 2002;16:255-256.
  11. Heedman PA, Starkhammar H. Patterns of referral to a palliative care unit: an indicator of different attitudes toward the dying patient? J Palliat Med. 2002;5:101-106.
  12. Ahmed N, Bestall JC, Ahmedzai SH, Payne SA, Clark D, Noble B. Systematic review of the problems and issues of accessing specialist palliative care by patients, carers and health and social care professionals. Palliat Med. 2004;18:525-542.