Admission demands in palliative care units: Delays evaluation

In spite of public health priority, the supply of beds in palliative care units (PCU) remains low regarding estimated needs. PCUs receive a high number of demands for admission. They have to select patients through applications with strict criteria and write them down on a waiting list. Still, accepted demands do not always result in patient's admission. Demands can be over when a place is available. To understand what seems like an obstacle to access palliative care, we have studied the evolution of faxed demands for admission to the Paul-Brousse PCU in 2008. Out of the 413 received applications, 293 (70.9%) met the criteria and 81 patients (19.5%) were actually admitted. From the day of reception of the applications, the median time is 1 day to give a request a principle agreement and 6 days to actually admit a patient in the unit. A quarter of accepted demands are not followed by admission because of patients' death in this 6-day period. Finally, those indicators could be used in the healthcare management program to adapt offer and needs in PCU. (C) 2010 Elsevier Masson SAS. All rights reserved.