Evaluating the Need for Palliative Care Services at a General Hospital in Israel

Background: Most hospitals in Israel do not provide palliative care beds and only few general hospitals have palliative consultation services. To date there are no data on the rate of hospitalizations and the need for palliative care in general hospitals in Israel. Objective: The objective was to characterize patients in need of palliative treatment during hospitalization in a general hospital in Israel. Methods: A retrospective review was performed of a random sample of files of patients admitted to the Internal Medicine Department at the Soroka University Medical Center (SUMC) between May 2007 and April 2008. Patients were defined as in need of palliative care if they had a CARING score 13. The data were collected using a structured questionnaire that included sociodemographic data and data on comorbid conditions, main complaints, primary diagnosis, duration of hospitalization, and hospitalization outcome. Results: We reviewed 2795 hospitalizations. Of these, 14.9% were defined as in need of palliative care. Fourteen percent of the patients died during hospitalization and 47% died over the six-month follow-up period. The most common primary diagnosis was malignancy (61%), followed by end-stage pulmonary disease (19%) and Alzheimer's and other causes of dementia (9%). In only 12 hospitalizations (3.5%) was palliative care arranged for patients at discharge. Conclusions: A high percentage of patients hospitalized in internal medicine divisions could benefit from palliative care. The data presented here could aid hospitals in the integration of palliative care services.