Background: Integration of palliative care into stroke care remains inconsistent, and population-level evidence describing how inpatient specialist palliative care is documented within patterns of hospital admissions in the final year of life remains limited.
Aims: To describe patterns of hospital admissions in the final year of life among patients who died from stroke, examine how inpatient specialist palliative care is documented within these admission patterns, and characterise variation across stroke subgroups.
Methods: Retrospective population-based data linkage study of adults aged ≥18 years who died from stroke in Queensland, Australia (2009–2019). Linked mortality and hospital administrative datasets were used to identify inpatient admissions and documented palliative care episodes in the final 12 months of life.
Results: Among 16,366 patients who died from stroke, 13,065 (79.8%) had ≥1 hospital admission in the final year of life (26,925 admissions; median 2, IQR 1–3). Hospital admissions were concentrated near death, with 71.1% of final admissions commencing within 7 days and 62.9% of patients dying during their final hospitalisation. Inpatient specialist palliative care was documented for 25.0% of patients, with first documentation occurring a median of 5 days before death and 92.3% recorded within the final week. Patients with documented specialist palliative care had greater neurological deficit and vascular comorbidity.
Conclusions: The last year of life is characterised by recurrent admissions, within which inpatient specialist palliative care is often documented during the final admission. These findings indicate that documented inpatient specialist palliative care is concentrated late during the final year of life.