Australia is leading the way in establishing a national system (the Palliative Care Outcomes Collaboration - PCOC) to measure outcomes and quality of specialist palliative care services benchmark across country. This article reports on analysis data collected routinely at point-of-care 5939 patients treated by first fifty one that voluntarily joined PCOC. By March 2009, 111 have agreed join PCOC, representing more than 70% 80% nationally. All states territories are involved this unique...

Background: The concept of palliative care consisting five distinct, clinically meaningful, phases (stable, unstable, deteriorating, terminal and bereavement) was developed in Australia about 20 years ago is used routinely for communicating clinical status, planning, quality improvement funding. Aim: To test the reliability acceptability revised definitions Palliative Care Phase. Design: Multi-centre cross-sectional study involving pairs clinicians independently rating patients according to...

Every health care sector including hospice/palliative needs to systematically improve services using patient-defined outcomes. Data from the national Australian Palliative Care Outcomes Collaboration aims define whether patients' outcomes and consistency of these have improved in last 3 years.Data were analysed by clinical phase (stable, unstable, deteriorating, terminal). Patient-level data included Symptom Assessment Scale Problem Severity Score. Nationally collected point-of-care anchored...

Objective: Design, setting and subjects: An analysis of the health records 720 7375 people in detention financial year 1 July 2005 – 30 June 2006, with oversampling those detained for > 3 months. Main outcome measures: Health encounters condition categories; estimated incidence rates new conditions, mental injuries each cohort (defined by time in, reason for, detention). Results: People had an 1.2 (95% CI, 1.18–1.27) per person-week. Those 24 months particularly poor health, both physical....

To compare reasons identified by clinical staff for potential primary care attendances to the ED with those previously patients.Survey of and patients in five New South Wales, Australia using questionnaire based on published studies.Clinicians survey identify a broader spectrum cases presenting than themselves report. Doctors reported average 4.1 very important nurses 4.8 compared 2.4 reasons. The main both doctors were similar quite different patients. Clinicians more likely emphasize cost...

Objective. Chronic pain is experienced by one in five Australians and estimated to be the nation's third most costly health problem. In 2013, a chronic treatment outcomes registry was established, with goals of evaluating multidisciplinary centers, establishing benchmarking system drive quality improvement providing answers important questions regarding types ("dose," intensity, response) which appropriate for different patients. This paper describes development first-phase implementation...

Background Very few measures are used successfully as part of routine care within national palliative outcome programs. Only a handful studies examine these measures. The aim this study is to evaluate the validity measure in outcomes program: Palliative Care Outcomes Collaboration Symptom Assessment Scale (PCOC SAS). Methods A retrospective multi-site cohort with secondary analysis routinely collected patient-level data assess PCOC SAS’s internal consistency, construct validity, reliability,...

To develop a palliative care casemix classification for use in all settings including hospital, hospice and home-based care.3866 patients who, three-month period, had 4596 episodes of provided by 58 services Australia New Zealand.A detailed clinical service utilization profile was collected on each patient with staff time other resources measured daily basis. Each day costed using actual cost data from study site. Regression tree analysis used to group similar costs characteristics.In the...

In Australia, patients at the end of life with complex symptoms and needs are often referred to palliative care services (PCSs), but little is known about receiving in different settings.To explore patients' levels pain other while from PCSs.PCSs registered through Australia's national Palliative Care Outcomes Collaboration (PCOC) were invited participate a survey between 2008 2011. Patients (or if unable, proxy) complete Outcome Scale.Questionnaires completed for 1800 patients. One-quarter...

Background: The Palliative Care Problem Severity Score is a clinician-rated tool to assess problem severity in four palliative care domains (pain, other symptoms, psychological/spiritual, family/carer problems) using 4-point categorical scale (absent, mild, moderate, severe). Aim: To test the reliability and acceptability of Score. Design: Multi-centre, cross-sectional study involving pairs clinicians independently rating tool. Setting/participants: Clinicians from 10 Australian services: 9...

Objectives: To provide a nontechnical discussion of the development palliative care casemix classification and some policy implications its implementation. Sample: 3866 patients who, in three month period, had 4596 episodes provided by 58 services Australia New Zealand. Method: A detailed clinical service utilization profile was collected on each patient with staff time other resources measured daily basis. statistical summary variables compiled as first stage analysis. Results: Palliative...

A range of health outcomes at a population level are related to differences in levels social disadvantage. Understanding the impact any such palliative care is important. The aim this study was assess, by socio-economic disadvantage, referral patterns specialist and proximity inpatient services. All community services nationally were geocoded (using postcode) one standardised measure deprivation – Socio-Economic Index for Areas (SEIFA; 2006 census data). Referral characteristics referrals...

Objectives To explore differences in severe symptom outcomes for palliative care patients receiving hospital compared with those at home. Methods Change distress from the start of an episode to just prior death was measured 25 679 who died under a or home-based team between January 2015 and December 2016. Logistic regression models controlled home enabled comparison number symptoms death. Results All improved over 85% all had no Pain control illustrates this 7.4% reporting pain 2.5% When...

Objectives In the increasingly competitive environment of aged care in Australasia, how can providers and consumers be sure that support delivered is efficient makes a positive difference? Monitoring outcomes has long been emphasised for ensuring quality service delivery, yet there currently no consistently applied approach available. Methods This paper considers importance measuring community reports on development field trial Australian Community Care Outcomes Measure ( ACCOM ). The...

The aim of this work was to analyze routine assessments recorded, when a patient documented as likely die in hours days, determine the prevalence, intensity, and associations physical symptoms.Although death inevitably occurs, very little prospective data describe at population level symptoms confronting imminently dying people.Using prospectively collected from participating palliative care services Australian Palliative Care Outcomes Collaboration between July 1, 2013, December 31, 2014,...

When capturing patient-level outcomes in palliative care, it is essential to identify which outcome domains are most important and focus efforts capture these, order improve quality of care minimise collection burden.To determine for measurement outcomes, the optimal time period over these should be measured.An international expert consensus workshop using nominal group technique. Data were analysed descriptively, weighted according ranking (1-5, lowest highest priority) domains....

Objective: To examine the performance of two widely used outcome measures in public adult mental health services.Method: As part a larger study, clinical staff eight New Zealand District Health Board areas collected consumer outcomes data for period 6 months. Among other measures, Nation Outcome Scales (HoNOS) and Life Skills Profile (LSP-16) were completed at start end episodes care, as well 90-day reviews.Results: The these twomeasures was examined relation to compliance with collection...

The selection of patients for rehabilitation, and the timing transfer from acute care, are important clinical decisions that impact on care quality patient flow. This paper reports utilization review data inpatients in with stroke, hip fracture or elective joint replacement, other referred rehabilitation. It examines reasons why level criteria not met explores differences decision making between rehabilitation teams around appropriateness readiness transfer. Cohort study a large referral...