LAUSR

Abstract Background: Community-based palliative care may potentially benefit patients by offering their preferred care at the end of life and benefit systems by reducing hospital use. Objective: To compare place of death and acute care hospital use in the last year of life between cancer decedents who did and did not access a community-based palliative care service (PCS). Design: Retrospective observational cohort study using linked individual administrative records from cancer registry, hospital, emergency department (ED), mortality, and PCS databases. Propensity score-weighted regression methods were used. Setting/Subjects: Whole of population study incorporating 28,561 West Australian cancer decedents from 2001 to 2011. Measurements: Exposure was defined as ever/never accessed PCS. Outcomes were place of death (in/out of hospital) and the number, length of stay, and cumulative cost of hospital admissions at the end of life. Results: Decedents who accessed the service (n = 16,530) had triple (adjusted o...