Health Services used by Cancer Patients During the Terminal Three Months

Abstract

The Australian population has just passed the 16 million mark, and as Australians live in an expanse as large as the United States, you will guess that they may present problems in palliative care which differ in some ways from those in more densely settled parts of the world. However, for city dwellers the differences are smaller. The present study included no country patients. We worked in Sydney, which now has some 3.5 million people in its urban area, but there were rather fewer in 1982, the year on which our study was based, The reason why we had to go so far back was that our under-computerized Cancer Registry could give us no more recent figures. Our patients were investigated posthumously. They had all been seen at the Royal North Shore Hospital, which is an 800 bed teaching hospital with excellent oncology services, other than those for palliative care. Within its patient catchment area there were also two terminal care hospitals — I hesitate calling them hospices at that stage — with altogether 75 beds. The reasonably well organised community services, including domiciliary nursing services, were then still getting into their full stride, and so their extent was not universally known. Altogether in 1982 palliative care was far less developed in Australia than in this country, but we have tried hard since then to catch up.