Insights into hospitalisation of advanced cancer patients: a study of medical records

1. Adam Bostanci MSc, MPhil, PhD Senior Research Fellow^1,*, 
2. Dell Horey PhD Senior Lecturer², 
3. Kate Jackson MBBS, DTM&H, FRCA, FAChPM, FFPMANZCA Medical Director³, 
4. Leeroy William BSc (Hons), MBBS, MRCGP, FAChPM Palliative Medicine Specialist³, 
5. Lise Pittmann BSW, MScApp Program Manager⁴, 
6. Jennifer Ward BSc, BSW, MSW Social Worker³, 
7. Gaye Moore BN (Hons), MPH, PhD Research Fellow⁵, 
8. Peter Martin MB, BCh, BAO, MMed Clinical Director⁴, 
9. Peter Hudson RN, PhD Director¹ and
10. Jennifer Philip PhD, FAChPM, MMed, GDipPallMed, MBBS Deputy Director¹

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Keywords:

• cancer;
• place of death;
• qualitative research;
• multidisciplinary care team

The aim of this study was to explore reasons for the hospitalisation and place of death outcomes of terminal cancer patients. 

The methodology involved a qualitative content analysis of medical records pertaining to the last 3 months of life of 39 patients with one of four malignancies: prostate, breast, lung, or haematological.

 The results presentation is organised around three themes: decision hierarchy in health care, meanings of ‘home’, and late recognition of dying.

 Based on the detailed findings, this paper suggests that important insights into the broader goals of advanced cancer patients are offered by allied health staff, and that more effective use of the multidisciplinary team may support endeavours to achieve more home deaths for cancer patients who want this outcome. 

The analysis also provides new insights into the meaning of ‘home’ in interactions between advanced cancer patients and health professionals. 

The wish for ‘home’ appears bound up with other patient goals and the implications of this are discussed.