Dr Animut Alebel Ayalew, Dr Arjun Poudel1, Dr Keryn Johnson1, Dr Jack Thepsourinthone1, Mss Stacey Heer1, Dr Lisa Redwood1, Professor Judy Mullan1, Professor Andrew Bonney1, Associate Professor Deidre Morgan2, Distinguished Professor Patsy Yates3, Professor Katherine Clark4, Professor Kirsten Auret5, Mss Sabina Clapham1
1University of Wollongong, Wollongong, Australia, 2Flinders University, Adelaide, Australia, 3Queensland University of Technology, Brisbane, Australia, 4University of Sydney, Sydney, Australia, 5University of Western Australia, Perth, Australia
Biography:
Dr Animut Ayalew is a Research Fellow at the Australasian Health Outcomes Consortium, Faculty of Science, Medicine and Health, University of Wollongong. His research focuses on palliative-care outcomes, health-service evaluation, and the development of data-driven tools to improve clinical decision-making. He serves as the statistician for the National Palliative Care Coordination (NPCC) Project. Dr Ayalew has a strong background in clinical practice, advanced statistical modelling, and implementation research. His work aims to strengthen evidence-based, equitable, and person-centred care across health systems.
Abstract:
Background:
Although general practitioners (GPs) play a central role in enabling timely access to palliative care, evidence on palliative care utilisation and the duration of care among patients referred by GPs is scarce.
Aim:
To examine palliative care utilisation among GP-referred patients, estimate the duration of care, and identify predictors of care among those who died following referral.
Methods:
A multicentre retrospective cohort study was conducted using Australian Palliative Care Outcomes Collaboration data. Patients referred to palliative care by GPs between 1 July 2019 and 30 June 2024 were included. Binary logistic regression examined factors associated with palliative care utilisation, and quantile regression was used to identify predictors of duration of palliative care before death.
Results:
Of 25,124 GP-referred patients, 92.2% were admitted in community palliative care, and 44.4% died during the study period, with most deaths (81.3%) occurring within three months of referral. Admission to inpatient palliative care was more likely among patients with cancer and those experiencing distress from breathlessness, nausea, or psychological/spiritual problems, and less likely among those with higher functional status, older age, distress from appetite or fatigue, and family/carer problems. Among those who died, shorter duration of palliative care was associated with inpatient care, functional decline, distress from pain, breathlessness, and family/carer problems.
Conclusions:
GPs predominantly refer patients to community-based palliative care, with most patients commencing palliative care close to death and receiving a duration shorter than recommended. Future research in primary care, exploring needs-based referral models and referral acceptance may support timely access and comprehensive care.
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