{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:21:18Z","timestamp":1777922478803,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Medical Research Future Fund Palliative and End of Life Care"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine patterns of emergency department (ED) presentation and emergency hospital admission in the last 90 days of life for residents of New South Wales, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective audit of electronic clinical records. Descriptive statistics report patterns of ED presentation and emergency hospital admission in the last 90 days of life, and symptom drivers of ED presentation. Logistic regression identifies factors associated with low versus high rates of ED presentation and emergency admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>2869 ED presentations are included across 1730 decedents. 80% of ED visits led to admission. 92% of people had at least 1 ED presentation in the final 90 days of life, with 18% having 3 or more. 86% of people had at least 1 emergency admission, with 9.5% having 3 or more. Odds of high ED use and high admissions were increased for people with cancer and those under 70 years. ED visits were long and often involved multiple investigations, but a small number of patients required no investigations. Common symptom drivers of ED attendance were pain, breathlessness, and confusion\/delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ED presentations in the final months of life are common, and investigations are often required to assess for potentially reversible problems. Some people approaching end of life require admission to hospital via ED without the need for investigations, so may be seeking help for escalating nursing needs. Alternative models of care are needed to support escalating nursing needs at home, and funding for palliative services must keep pace with the rising demand.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08258597251413029","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T18:31:13Z","timestamp":1769106673000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergency Department Use in the Last 90 Days of Life: A Retrospective Audit Regression Analysis"],"prefix":"10.1177","author":[{"given":"Thomas Richard","family":"Osborne","sequence":"first","affiliation":[{"name":"Central Coast Local Health District"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6187-4703","authenticated-orcid":false,"given":"Zoi","family":"Triandafilidis","sequence":"additional","affiliation":[{"name":"Central Coast Local Health District"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7253-1511","authenticated-orcid":false,"given":"Sarah Yeun-Sim","family":"Jeong","sequence":"additional","affiliation":[{"name":"University of Sydney"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8549-1934","authenticated-orcid":false,"given":"Stuart","family":"Szwec","sequence":"additional","affiliation":[{"name":"Hunter Medical Research Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Leigh","sequence":"additional","affiliation":[{"name":"Hunter Medical Research Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Goodwin","sequence":"additional","affiliation":[{"name":"Central Coast Local Health District"},{"name":"Centre for Research in Health System Performance, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"issue":"11","key":"e_1_3_3_2_2","first-page":"900","article-title":"Emergency medical care in developing countries: Is it worthwhile?","volume":"80","author":"Razzak JA","year":"2002","unstructured":"Razzak JA, Kellermann AL. Emergency medical care in developing countries: Is it worthwhile? Bull World Health Organ. 2002;80(11):900\u2013905.","journal-title":"Bull World Health Organ"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/08258597211050740"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejm197603112941104"},{"key":"e_1_3_3_5_2","volume-title":"Cost of potentially preventable hospitalisations in Australia, 2014\u201315 to 2023\u201324","author":"Australian Institute of Health and Welfare","year":"2025","unstructured":"Australian Institute of Health and Welfare. Cost of potentially preventable hospitalisations in Australia, 2014\u201315 to 2023\u201324. Australian Institute of Health and Welfare; 2025."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2011.tb03106.x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-1202-8"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.14331"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/10499091211055903"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216317713428"},{"key":"e_1_3_3_11_2","unstructured":"Makwana A Pring A Bowtell N Verne J. Emergency admissions in the 3 months before death. Accessed August 26 2025. https:\/\/www.gov.uk\/government\/publications\/emergency-admissions-in-the-3-months-before-death\/emergency-admissions-in-the-3-months-before-death."},{"issue":"1","key":"e_1_3_3_12_2","article-title":"51 Emergency hospital admissions near the end of life","volume":"14","author":"Pring A","year":"2024","unstructured":"Pring A, Westwood J, Bowtell N, Verne J. 51 Emergency hospital admissions near the end of life. BMJ Support Palliat Care. 2024;14(Suppl 1):A20\u2013AA1.","journal-title":"BMJ Support Palliat Care."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2010.00907.x"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/cky241"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/082585970802400404"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.23696"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909112447285"},{"key":"e_1_3_3_18_2","unstructured":"Australian Bureau of Statistics. Causes of Death Australia [Internet]. Canberra: ABS; 2025. p. [cited 2025 November 16]. Available from: https:\/\/www.abs.gov.au\/statistics\/health\/causes-death\/causes-death-australia\/4."},{"key":"e_1_3_3_19_2","author":"Palliative Care New South Wales","unstructured":"Palliative Care New South Wales. Palliative Care New South Wales. Palliative Care funding attracting important attention. 2025-08-26. doi: https:\/\/palliativecarensw.org.au\/palliative-care-funding-attracting-important-attention\/.","journal-title":"Palliative Care New South Wales. Palliative Care funding attracting important attention"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2021-002889"},{"key":"e_1_3_3_21_2","unstructured":"Australian Bureau of Statistics. Census of Population and Housing 2016 and 2021. 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