• Rachel Everitt, Neil Robinson, David Marco, Jennifer Weil, and Tamsin Bryan.
• Department of Palliative Medicine, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
• Palliat Med. 2021 Sep 1; 35 (8): 1508-1513.

BackgroundCOVID-19 has led to implementation of wide-ranging social restriction measures with consequent impact on health care utilisation in many domains. There is little published data on the experience of palliative care services catering to a population with low case numbers of COVID-19.AimThis study aimed to consider the impact of COVID-19 on utilisation of inpatient palliative care in the context of low community transmission, and low numbers of cases in hospital.DesignA retrospective service evaluation examining differences in number of admissions, diagnoses, number of deaths and time from admission to death, across three discrete 8-week time periods spanning the early COVID-19 pandemic.Setting/ParticipantsAll admissions (n = 194) to a metropolitan tertiary hospital inpatient palliative care unit in Melbourne during the study period.ResultsAn initial 16.9% fall in admissions was followed by a return to baseline admission numbers, with a 46.7% increase in number of deaths compared to baseline. The number of deaths within 24 h rose from 10.8% to 37.3% (p < 0.01). The number of patients with non-malignant diagnoses increased from 32.4% to 52%, and those with non-malignant diagnoses were more likely to die rapidly (p < 0.01). There were no patients with COVID-19 infection.ConclusionIncreased numbers of deaths within 24 h of admission occurred on the palliative care unit despite low COVID-19 case numbers in the wider community, and in the setting of widespread social restriction measures. More research is needed examining the health-related consequences of such restrictions for individuals not infected with COVID-19.

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