Objectives: To document the access to early palliative care for people who die of cancer in Victoria, and to understand the impact of early palliative care on the quality of end-of-life.
Design: Retrospective, population-based, cohort study. Data was sourced from the Victorian Cancer Registry, linked to inpatient and non-admitted health service use and emergency data in the 12 months prior to death.
Setting and participants: Victorians who died from cancer between January 2018 to January 2023.
Main outcome measures: Rates of palliative care and early palliative care provision, defined as at least 90 days before death; quality of end-of-life metrics in patients receiving early vs late palliative.
Results: We analysed 53,305 deaths across the study period. Palliative care was provided in 72.6 per cent of cases. This reduces to 32.7 per cent receiving early palliative care. Early palliative care was associated with a lower likelihood of chemotherapy, two or more emergency department visits, two or more acute visits and an acute stay of more than 14 days in the last 30 days of life; and a higher likelihood of having an advance care plan at death and dying outside an acute hospital bed.
Conclusion: Our study reveals that while overall nearly three quarters of people who die from cancer will access palliative care, the rates of early palliative care are around 30 per cent and falling. When palliative care is delivered early, end-of-life care is improved. This disparity between low rates of early palliative care and improved outcomes for those who receive it sets out an important call for action.