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Table 2 Summary of key points

From: The ‘problematisation’ of palliative care in hospital: an exploratory review of international palliative care policy in five countries

Country Year Authors Summary of key points relating to hospital palliative care
Australia 2010 Policy makers • People prefer to be cared for and die at home yet most die in hospital
• Potential for cost savings by avoiding inappropriate hospital admissions
• Burden of hospitalisation on the health care system and poor quality of death in hospital
England 2008 Advisory board supported by 6 key work groups • People prefer to be cared for and die at home yet most die in hospital
• Key strategy aim to reduce number of hospital deaths
• Lack of community responsiveness results in admissions and prolonged hospital stay
• Improved community provision reduces admissions enabling people to die in place of choice
• Poor quality of care in hospitals
• Care for dying people is a core role of the hospital in the ‘foreseeable future’
Ireland 2001 National advisory committee of clinicians, leaders and policy makers • People prefer to be cared for and die at home yet most die in hospital
• Unresponsive community services result in emergency hospital admissions
• More investment in community services would reduce unnecessary hospital admissions
• Poor quality of care in hospitals
Singapore 2011 Workgroup comprising of health professionals • More understanding needed regarding people’s preferences at the end of life including preferences for place of care in Singapore
• Majority of patients are admitted to hospital for symptom control and more patients are cared for in hospital than necessary
• Home care teams need to be able to provide treatment at home to reduce the need for hospital admissions
• Patients identified late have poorer outcomes of care and unnecessary hospital admissions
Switzerland 2009 Government based steering committee and expert working groups comprising of experts in palliative care • Most people die in nursing homes yet the majority prefer to die at home
• Adequate community based services enable people to stay at place of choice and avoid unnecessary hospital admissions
• The patient should be supported to choose where they would like to spend their last phase of life