Hospital-service use in the last year of life by patients aged ⩾60 years who died of heart failure or cardiomyopathy: A retrospective linked data study

Abstract

Background: Understanding patterns of health care use in the last year of life is critical in health services planning. Aim: To describe hospital-based service and palliative care use in hospital in the year preceding death for patients who died of heart failure or cardiomyopathy in Queensland from 2008 to 2018 and had at least one hospitalisation in the year preceding death. Design: A retrospective data linkage study was conducted using administrative health data relating to hospitalisations, emergency department visits and deaths. Participants and setting: Participants included were those aged ⩾60 years, had a hospitalisation in their last year of life and died of heart failure or cardiomyopathy in Queensland, Australia. Results: Of the 4697 participants, there were 25,583 hospital admissions. Three quarters ( n = 3420, 73%) of participants were aged ⩾80 years and over half died in hospital ( n = 2886, 61%). The median number of hospital admissions in the last year of life was 3 (interquartile range [IQR] 2–5). The care type was recorded as ‘acute’ for 89% ( n = 22,729) of hospital admissions, and few ( n = 853, 3%) hospital admissions had a care type recorded as ‘palliative.’ Of the 4697 participants, 3458 had emergency department visit(s), presenting 10,330 times collectively. Conclusion: In this study, patients who died of heart failure or cardiomyopathy were predominantly aged ⩾80 years and over half died in hospital. These patients experienced repeat acute hospitalisations in the year preceding death. Improving timely access to palliative care services in the outpatient or community setting is needed for patients with heart failure.