A new study from Swansea University, U.K., using population-scale data, has revealed insights into how people use health and care services in their final year of life and highlights the need for better identification and support for people needing palliative care.
The research, published in The Lancet Regional Health—Europe, found that most people spent their last year of life at home, but demand for urgent care increased sharply near death.
People who were registered for palliative care used more health and care services from home but those in care homes—both with and without nursing—used these services less. It was also found that people who were registered for palliative care were discharged from urgent hospital settings at a faster rate and so experienced shorter emergency hospital stays than those who were not registered for palliative care.
It also uncovered disparities in access to palliative care, with men, urban residents, people living alone, and those in deprived communities being under-represented on the palliative care register.
The research team says that their study reveals an urgent need to identify people who would benefit from palliative care earlier and to provide additional support in home settings, especially to underserved groups. At a time when health and social care systems face mounting pressure, the research indicates that system-level planning and data-driven strategies are also required to manage the rising demand for end-of-life services.
Research lead Professor Rhiannon Owen from Swansea University’s Faculty of Medicine, Health and Life Science said, “This work enabling a system-wide evaluation for the entire population of Wales was only made possible by linkage of anonymous health and administrative data facilitated by the SAIL Databank. Our findings provide a vital evidence-based foundation to support ministerial policy for designing more efficient, compassionate, and equitable end-of-life care in Wales.”
The research work was conducted in response to the National Program for Palliative and End of Life Care in Wales and commissioned by the Welsh Government via the Health and Care Research Wales Evidence Center.
More information:
Rhiannon K. Owen et al, Health and care service utilisation in the last year of life before non-sudden death in Wales, 2014–2023, by palliative care registration: a population-based retrospective cohort study, The Lancet Regional Health – Europe (2025). DOI: 10.1016/j.lanepe.2025.101479
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