A groundbreaking study investigating the associations between the availability and timing of digitally available advance care planning (ACP) documents and hospital use and costs during the last six months of a person's life was recently published in the prestigious medical journal, BMJ Open.
The study, titled Association of advance care planning with hospital use and costs at the end of life: a population-based retrospective cohort study was authored by Prof Ian Scott and Prof Liz Reymond from Metro South Health, and Xanthe Sansome and Hannah Carter.
The study found that:
- Digitally accessible, standardised ACP documents, completed greater than six months before death, are associated with decreased Emergency Department presentations, hospital and ICU admissions, and in-hospital deaths compared with matched controls.
- In addition, documents uploaded greater than six months before death were associated with decreased hospital costs compared to controls.
- It is likely that more patient benefits and less hospital costs accrue if ACP documents are completed in a proactive manner, with longer lead times prior to death rather than reactively in response to imminent death.
Prof Reymond said that the investigation took place across 11 Queensland public hospitals and included records from nearly 17,000 patients, 5,586 of whom had standardised ACP documents uploaded to the Queensland Health electronic hospital record using the ACP Tracker, which is managed by the Statewide Office of Advance Care Planning.
“Those documents were available in real time to inform care for Queensland Health treating teams and the Queensland Ambulance Service, as well as to the person’s GP and/or the person’s residential aged care facility,” Prof Reymond said.
“Queensland is the first State or Territory in Australia to have a statewide, standardised clinical approach to receive, review and upload ACP. This approach is led by the Statewide Office of Advance Care Planning, which is hosted by Metro South Health.”
Clinicians wanting to learn more about the benefits of ACP can register for the 2025 ACP Week Virtual Forum.
This free education event will explore a patient’s journey through the ACP lens and feature:
- a keynote address from Prof Reymond about the study
- expert speakers sharing real-world strategies that can be applied to support patients, families and healthcare teams.
If you would like to learn more about ACP in the Metro South region, contact the MSH ACP Service.