Suggestions for Improving the Palliative Care Outpatient Department through a Review of Palliative Care Visits

ABSTRACT

Aims: To explore unmet needs and enhanced outpatient care functions of palliative care for patients with cancers, scrutinized records of outpatient visits in acute care and regional designated cancer hospital. Methods: A retrospective study was made for a total of 3136 consecutive visits from electronic records between April 2020–March 2023. Results: There were 630 unscheduled visits (20.1%) with 74.0% of them occurring during working hours; a quarter of unscheduled visits were after-hours. Of the total visits, 347 visits (11.1%) resulted in emergent admissions, and of the unscheduled visits, 305 cases (48.4%) were emergent admissions. Ambulances were called in 196 cases (56.5%) of emergent admissions. Moreover, the reasons for unscheduled visits statistically differed from reasons for non-admission cases (p<0.01). Conclusion: Patients’ illness trajectories and our results revealed that palliative care patients with cancers often experience unexpected physical and mental changes. To establish more effective outpatient care, we should construct structures to be available 365 days a year for palliative care patients and to instruct patients and their care givers in advance about warning signs for admission and how to access medical services.