School of Occupational Therapy and Social Work, Curtin University of Technology, Perth, WA. l.rosenwaxATcurtin.edu.au
Med J Aust. 2011 Jun 6;194(11):570-3. doi: 10.5694/j.1326-5377.2011.tb03106.x.
To describe hospital and emergency department use in the last year of life by people for whom death from cancer or one of another nine conditions was an expected outcome.
DESIGN, PARTICIPANTS AND SETTING: Retrospective cross-sectional study based on death registrations and morbidity data for 1071 Western Australians who died between 1 August 2005 and 30 June 2006. Decedents had an informal primary carer, did not live in residential aged care and died of a condition amenable to palliative care.
Total number of hospital admissions; emergency presentations (with and without hospital admission); days spent in hospital by age group at death, sex, metropolitan or rural place of residence and cancer versus non-cancer diagnosis; proportion in hospital on any day in the last 365 days of life; time points of change in the last 365 days of life at which there was an increasing proportion of hospital admissions for those with cancer and non-cancer conditions.
All but 4% of the decedents spent time in hospital with a marked increase in hospitalisations in the last 108 days of life for people who died of cancer and the last 83 days of life for people who died of non-cancer conditions. Those with cancer spent less time in hospital than those with other diagnoses. Seventy per cent of the cohort had at least one emergency presentation. On the last day of life, 61.5% of people were in hospital and 4.0% had been seen in emergency departments.
Western Australian hospitals currently provide extensive and progressively greater care at the end of life. Identifying patterns of emergency and inpatient use for various disease trajectories will assist in the planning of appropriate services for people where death is an expected outcome.
描述在癌症或其他九种预期死亡原因导致的生命末期，人们在医院和急诊部门的使用情况。
设计、参与者和设置：基于 2005 年 8 月 1 日至 2006 年 6 月 30 日期间在西澳大利亚去世的 1071 名患者的死亡登记和发病数据进行的回顾性横断面研究。死者有非正式的主要照顾者，不住在养老院，死于姑息治疗有效的疾病。
总住院人数；急诊就诊（包括和不包括住院）；按年龄组、性别、城市或农村居住地以及癌症与非癌症诊断划分的死亡时的住院天数；生命最后 365 天中每天住院的比例；生命最后 365 天中，癌症和非癌症患者住院人数增加的时间点。
除了 4%的死者外，所有人都在医院度过了一段时间，癌症患者在生命的最后 108 天和非癌症患者在生命的最后 83 天住院人数明显增加。癌症患者的住院时间少于其他诊断的患者。70%的患者至少有一次急诊就诊。在生命的最后一天，61.5%的人在住院，4.0%的人去过急诊部。
西澳大利亚的医院目前在生命末期提供广泛且逐渐增加的护理。确定各种疾病轨迹的急诊和住院使用模式将有助于为预期死亡的患者规划适当的服务。
