Association between referral-to-death interval and location of death of patients referred to a hospital-based specialist palliative care service

Abstract

Context: The time interval between palliative care referral and death may play a role in determining the last place of care and location of death of patients referred to palliative care teams. Objectives: To examine the association between the referral-to-death interval and location of death of patients referred to a hospital-based palliative care service in Singapore. Methods: A retrospective analysis of data from a palliative care service's administrative database was performed. Individual patient's referral-to-death interval was calculated using the date of first contact with the service and date of death. Multinomial regression analysis was done to determine the influence of referral-to-death interval in predicting death at home and in an inpatient hospice facility compared with death in hospital, separately by gender. Results: Of 842 patients, 52% were female and 56% were aged 65 years or older. Terminal cancer was the diagnosis for most patients (86%). Three hundred ninety patients (46%) died outside the hospital setting. A referral-to-death interval of ≥30 days (as opposed to