Palliative care and intermediate care units

16th March 2021

Research recently published in the journal BMC Medicine examines mortality data for older adults discharged from hospital to intermediate care units. The focus of care in these units is traditionally rehabilitation and recovery. However this research shows that 1 in 4 may die within a year of their admission. Therefore palliative care should be integrated into care for this group of patients transferring from hospital.

This is a novel national cohort study of adults admitted to intermediate care units in England using linked individual Hospital Episode Statistics and death registration data.

This is a patient group in transition between hospital and home who require intermediate care. The researchers examined the patient characteristics and the factors associated with mortality over 1 year post-admission to an intermediate care unit to inform priorities for care.

76,704 adults were admitted to 220 intermediate care units in 2016. This is an older cohort with median age 81 years living with multiple conditions. Over one in four died within a year of their index admission.  The traditional emphasis on rehabilitation and recovery in intermediate care units has changed with an ageing population and there is a need for greater integration of palliative care.

Patients admitted to community hospitals are in transition between hospital and home and require intermediate care. Our research showed this group were mainly older people with chronic progressive disease and multiple conditions. Over one in four were in the last year of life. Our findings revealed requirement for integrated geriatric and palliative care to support these patients with multiple care needs. Understanding care needs at a population level is vital to identify policy priorities to deliver high quality care. This work adds to the growing body of evidence of the need for more integrated and joined up models of care among our health services”.

– Dr Catherine Evans, Chief Investigator

Evans CJ, Potts L, Dalrymple U, Pring A, Verne J, Higginson IJ, Gao W; SPACE. Characteristics and mortality rates among patients requiring intermediate care: a national cohort study using linked databases. BMC Med. 2021 Feb 12;19(1):48. doi: 10.1186/s12916-021-01912-x. PMID: 33579284; PMCID: PMC7880511.