Authors (including presenting author) :
Cheung WY, Lam PT, Lam SK, Wong MS, Tsang WY
Affiliation :
Palliative Care Team, Department of Medicine & Geriatrics, United Christian Hospital
Introduction :
Palliative Care (PC) unit serve in-patients with complex PC needs and assist in their peaceful transition to terminal phase of life. In 2019, the average length of stay in United Christian Hospital PC unit was 11.6 days (vs HA mean 15.9 days). During the COVID-19 pandemic, due to operational reason, there was temporary closure of the PC beds from 26 March – 30 June 2020.
Objectives :
This is a retrospective review of the effects of closing PC beds on some administrative outcomes.
Methodology :
During the period from 1 April to 16 June 2020, information of patients with advanced cancer and non-cancer under our hospital specialist PC service was retrieved. Data including their hospital admissions, specialist in-patient PC consultations, percentage of use of extended care beds as well as lengths of stay were captured and reviewed.
Result & Outcome :
For patients under specialist PC service, there were a total of 143 episodes of hospital admissions via Accident & Emergency Department to acute medical beds during the study period. Forty-four patients (30.8%) were subsequently transferred to extended care beds for further management, which was higher than the percentage (20%) of extended care beds use by general medical patients. The average lengths of stay at acute and extended care beds were 7.0 and 20.7 respectively – both were longer than that of general medical patients (5.2 and 16.2 respectively). During the pandemic period 1 Jan- 30 June 2020, despite a significantly lower number total hospital admissions, the average monthly number of in-patient PC consultations remained high at 66.2, when compared to the monthly average of 90.8 in first half of 2019 (i.e. 66.2 / 90.8 = 73%).
Conclusion:
During the closure of PC beds, hospitalized PC patients had to rely on acute medical and extended care beds. Their PC needs did not disappear during the pandemic. A high proportion of PC patients in acute beds required specialist in-patient consultation, and their usage of extended care beds were also high. Their length of stay in both acute and extended care beds were also longer than that of general medical patients. All these may imply that without PC beds, there was mismatch between specialist care and patient needs. Specialist PC service is essential even in the midst of COVID-19 pandemic. Closure of PC beds did affect certain administrative outcomes. Further studies can be conducted to explore the effects of PC consultative service on them.
