Comparing Severe Symptom Distress of Inpatients and People Cared for in the Community in Their Last Week of Life: A National, Consecutive Cohort Study

Background: Understanding how symptom outcomes vary by care setting helps optimize care. Aim: To compare trajectories of severe symptom distress in the final week of life across community and hospital settings. Design: This retrospective consecutive cohort study used point-of-care data from the Australian Palliative Care Outcomes Collaboration, which includes the Symptom Assessment Scale and Palliative Care Problem Severity Score. Mixed-effects logistic regression models were adjusted for clinical, demographic and temporal factors. Setting/Participants: Australian palliative care services ( n = 165) contributed data for people who died between July 1, 2019, and June 30, 2024. Results: Of 141,691 patients,73.6% were inpatients; 61.0% had a cancer diagnosis. Severe symptom prevalence was generally low (