• Bridget M Johnston, Barbara Daveson, Charles Normand, Karen Ryan, Melinda Smith, Regina McQuillan, Irene Higginson, Lucy Selman, Katy Tobin, and BuildCARE.
• Centre of Health Policy and Management (B.M.J., C.N., M.S.), School of Medicine, Trinity College Dublin, Ireland. Electronic address: BJOHNST@tcd.ie.
• J Pain Symptom Manage. 2022 Aug 1; 64 (2): 137-145.

ContextThere is limited evidence about which elements and characteristics of palliative care service provision improve the experiences of older people living with life-limiting illness.ObjectivesTo evaluate older patients' (≥65 years) preferences for elements of services and supports and to explore relationships between patient characteristics and the patterns of preferences.MethodsA cross-sectional survey undertaken in Ireland and England using a Discrete Choice Experiment with people accessing specialist palliative care services. A random-effects probit model was used to estimate patient preferences.ResultsOf the 77 patients were interviewed, 51 participated in the Discrete Choice Experiment component of the interview (response rate = 66%). Participants prioritized support that minimized unpaid caregiver burden (P < 0.001). They also preferred ease of access to services including out-of-hours access (P < 0.001) and free care at home (P < 0.001). Quality of life was prioritized over quantity of life (<0.001).ConclusionPeople living with a life-limiting illness value care that focuses on quality of life, ensures barrier-free access to services and provides sufficient support for relatives. In the context of limited resources and growing demand for care, this study provides evidence about the service elements palliative care delivery models should prioritize and evaluate.Copyright © 2022. Published by Elsevier Inc.

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