Palliative care growing – but is it enough?

A new report from the Australian Institute of Health and Welfare (AIHW) provides insights into how Australians are accessing palliative care.

Spending on government subsidised palliative care treatment increased more than 30 per cent over the last four years from $5.2 million to $6.8 million.

Western Australia had the highest rate of palliative care treatments, more than double the national average, followed by the ACT and NSW.

The number of palliative medicine specialist services increased by a quarter (26%) from 69,673 services in 2013–14 to 87,805 - an average annual increase of 6%. As a proportion of the population, this represents an 18.5% increase over the four-year period.

The median age of palliative care patients was 77 and cancers were the main reason they sought treatment.

The three most frequently recorded diagnoses were lung cancer (16.7%), colorectal (bowel) cancer (8.4%) and other gastro-intestinal cancers (7.3%) — a result similar to 2017.

Surprisingly perhaps, palliative care patients mostly came from higher socio-economic backgrounds and received the treatment in hospital.

About 8 in 10 (78.7%) inpatient episodes lasted between 1 and 14 days (including same-day), whereas around 3 in 5 (63.5%) community episodes were 15 days or longer.

What is palliative care?

The Royal Australian College of Physicians describes palliative medicine as “the specialist care of people with terminal illnesses and chronic health conditions in community, hospital and hospice settings. Palliative medicine treats the physical aspects of illness, but also integrates psychological and spiritual facets of patient care.”

Patients who are referred to palliative medicine specialists usually have:

  • intermediate and fluctuating needs that might result in unplanned use of hospital and other services, and/or
  • complex and persistent needs (physical, social, emotional or spiritual) that are not effectively managed through established protocols.

Is it enough?

With debates about end-of-life care occurring in several jurisdictions, there are questions about whether palliative care services are meeting the needs of the community.

In updating their Position Statement on Voluntary Assisted Dying, Palliative Care Australia have made it clear that “voluntary assisted dying is not part of palliative care practice”.

Further, they claim that there is “significant unmet need for high quality palliative care in Australia” and a need for “substantial coordinated investment by all jurisdictions”.

So, even if there was assisted dying legislation active in each state and territory, there is still a need for increased funding for high-quality palliative care.

Funding and resources needed across the board

National Seniors Australia also continues to campaign for increased funding to improve aged care services and to double the number of level 3 and level 4 home care packages.

We're also calling on governments, insurers and health providers to put the brakes on rising health costs, including out-of-pocket health costs which remain a massive concern for older Australians. We know this because you've told us.

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