Palliative care needs at a South African district hospital: A descriptive study using supportive and palliative care indicators tool South Africa

Abstract

Background Patients with advanced life-limiting diseases (ALLDs) are often admitted to district hospitals for acute curative care, resulting in delayed or omitted palliative care. Early identification by clinicians ensured better care, efficient resource use and prevented avoidable hospitalisations. This study aimed to determine the prevalence and profile of admitted adult patients with palliative care needs at National District Hospital (NDH). Methods This was a retrospective descriptive study. Investigators identified palliative care needs based on the Supportive and Palliative Care Indicators Tool South Africa (Supportive and Palliative Care Indicators Tool [SPICT]™-SA) criteria. Results Out of 297 patient records reviewed, 127 (42.8%) met the criteria for palliative care based on SPICT™-SA. The most common qualifying disease-specific diagnoses included infectious diseases (21.8%), neurological conditions (15.6%), dementia or frailty (13.6%), and kidney disease (15.0%), while cancer (including haematological malignancies) accounted for 10.9%. The general indicators qualifying for palliative care included frequent unplanned visits (39.3%), poor functional status (26.2%) and dependence on others for care (24.3%). Conclusion The findings pointed to a gap in recognising palliative care needs among hospitalised patients, especially those with non-malignant conditions. Introducing routine screening using the SPICT™-SA tool at the district level supported earlier identification and enabled planning of care. This led to improved patient outcomes and effective use of health system resources. Contribution The study demonstrated how routine screening with the SPICT™-SA tool during admission could help identify palliative care needs in a district hospital.