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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