Patient characteristics and palliative care eligibility in public vs. private emergency care: A cross-sectional observational study

CONTEXT: The rapid aging of the Brazilian population in recent decades has strained the healthcare system. A lack of chronic patient absorption in primary care has led to overloaded emergency departments, which handle preventable decompensation and care that could be managed at home. OBJECTIVES: To identify the demand for patients eligible for Palliative Care (PC), among patients in four Emergency Departments (ED) in a metropolitan region in Brazil. METHODS: This observational, cross-sectional study involved four emergency departments: two public university hospitals and two private hospitals. Patient data on gender, age, visit reasons, and comorbidities were collected, along with the Supportive and Palliative Care Indicators Tool (SPCIT-BR™), Palliative Performance Scale (PPS) assessments, and opioid use information. RESULTS: Of the 270 patients, 101 (37.4 %) were eligible for PC. Of these eligible patients, the median age was 70-years, 54.5 % were male and public EDs had 9-fold higher odds of palliative care eligibility. Age, dyspnea, and fever predicted palliative care eligibility. CONCLUSIONS: The present findings demonstrate the necessity of further implementation of palliative care programs, particularly in the public health system. Such integration could lead to a decrease in unnecessary ED visits and home-based care that reflects patient wishes.