Department of Statistics

Case study: Examining palliative care at Auckland City Hospital

Hospitals know that a proportion of people who are admitted for palliative care may not need to be there - but how many, and what factors lead to inappropriate admissions?

Dr Merryn Gott and her University of Auckland team explored these questions with the help of the Statistical Consulting Centre.

The study was undertaken at Auckland City Hospital, the country’s largest with 710 beds. Researchers started by asking clinical staff involved in end-of-life care what helped and hindered best practice in palliative care management and what sort of in-service education they thought they needed.

The SCC came into the picture when the project analysed the case notes of every patient in a two-week period to define the proportion and characteristics of inpatients with palliative care needs and identify the varying approaches to their treatment.

The information was coded and put into a widely-used software package called Statistical Package for the Social Sciences (SPSS), and it was analysed to find out what factors tended to predict an inappropriate admission for patients with on-going palliative care needs. Data cleaning and exploration was carried out with R, the statistical computing and graphics software developed at the Department of Statistics in the mid-1990s and now used all over the world.

The next phase of the study was an economic analysis of potentially avoidable admissions and an examination of hospital data to examine interventions amongst those inpatients with palliative care needs who died within six months of the census.

Merryn says that the results, yet to be published, will be used to develop the best possible service reconfiguration and sound workforce development plans.

The study, “Potentially inappropriate admissions/interventions amongst hospital in-patients with palliative care needs” is funded by the Health Research Council and Auckland District Health Board.