• J Napolskikh, D Selby, M Bennett, E Chow, K Harris, E Sinclair, and J Myers.
• Radiation Oncology, Odette Cancer Centre, Toronto, ON.
• Curr Oncol. 2009 Jan 1;16(1):49-54.

BackgroundCanadian data describing inpatient palliative care unit (PCU) utilization are scarce. In the present study, we performed a quality assessment of a 24-bed short-term PCU with a 3-months-or-less life expectancy policy in a tertiary care setting.MethodsUsing a retrospective chart review, we explored wait time (wt) for admission (May 2005 to April 2006), length of stay [los (February 2005 to January 2006)], and patient demographics.ResultsThe wt data showed 508 referrals, with 242 resulting in admissions (92% malignant diagnoses) and 266 not (82% malignant). The most common malignancies in both groups were gastrointestinal, lung, and genitourinary. Median wt for admitted patients was 6 days, varying with referral source, such as the same hospital, home, or another hospital (6, 4, and 8.5 days respectively). Most admissions (93%) occurred in 21 or fewer days. Patient death (52%), admission to another PCU (25%), and declined offer (10%) were common reasons for no admission. Median los for 219 admitted patients was 19 days (range: 0-249 days). Most patients (94%) died in the PCU; a minority were discharged.ConclusionsMany patients requiring PCU services are admitted within a few days of referral, especially patients with the least available support: those at home. However, half of the non-admitted patients die while waiting-a potential area for improvement. The los for admitted patients complied with the 3-month "expected lifespan" PCU policy. Results are significant, because ensuring quality of life for palliative care patients includes timely PCU access and sufficient los to address end-of-life needs.

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