Referral patterns to a palliative care service in rural Australia servicing indigenous Australians.

BACKGROUND: Territory palliative care (TPC) of the Northern Territory covers a population of 150000 over 400000 km² in urban, rural and remote settings. Thirty-two per cent of the population are indigenous Australians. There is little documentation of palliative services to the indigenous Australians.
METHODS: We retrospectively reviewed the referral characteristics of patients who died in or were discharged from the TPC over 6 months in order to define unique characteristics of palliative care of such a population.
RESULTS: The records of 151 consecutive patients were analysed, with a mean age 63 ± 17 years, 62% male, 59% non-indigenous, 70% urban dwellers and 71% referred for malignancies. Median time to separation was 69 days, with 33% discharged within 30 days, while 28% survived beyond 6 months. Eighty-two per cent of patients died, and of these 52% in the hospice. indigenous patients were more likely to be younger (54 vs 70 years), female (52% vs 29%), living rurally (52% vs 12%) and to die at home (47% vs 11%).
CONCLUSION: These data showed major differences from the largest Australian study published so far, based on a population of predominantly non-indigenous Australians. This study identifies for the first time how TPC needs to have an encompassing service plan and delivery model to cater for indigenous patients and people in remote locations.