title: Palliative care for patients with chronic obstructive pulmonary disease: exploring the landscape.
abstract: Patients with chronic obstructive pulmonary disease experience a substantial symptom burden, high levels of psychosocial need and significant mortality. This epidemiological study reveals that the majority of patients are cared for in the public hospital system (64%) and generally die in hospital (72%) with a number of identifiable predictors of 6-month mortality. Our results suggest that palliative care services need to be redirected from a community-based admission focus to a model that is responsive to emergency and acute care hospital systems.
authors.affiliation: Centre for Palliative Care, St Vincent's Hospital and University of Melbourne Palliative Medicine, St Vincent's Hospital School of Population Health, University of Melbourne Murdoch Childrens Research Institute, Royal Children's Hospital Palliative Care Service Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital Centre for Research Excellence in Patient Safety (CREPS) Department of Clinical Epidemiology, Biostatistics and Health Services Research, Melbourne University and Melbourne HealthDepartments of Medicine Medicine, Southern Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Philip
authors.forename: A
authors.initials: A
authors.lastname: Lowe
authors.forename: M
authors.initials: M
authors.lastname: Gold
authors.forename: C
authors.initials: C
authors.lastname: Brand
authors.forename: B
authors.initials: B
authors.lastname: Miller
authors.forename: J
authors.initials: J
authors.lastname: Douglass
authors.forename: V
authors.initials: V
authors.lastname: Sundararajan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000401:mortality / Q000628:therapy; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality / Q000628:therapy*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014739:Victoria / Q000453:epidemiology
keywords: chronic obstructive pulmonary disease; epidemiology; hospitalisation; palliative care