Development of specialist palliative care in Dutch hospitals between 2014 and 2020: a repeated survey.

Background: Specialist palliative care teams (SPCTs) have significant benefits for patients with advanced disease or frailty, including improved quality of life, greater satisfaction with care, and less potentially inappropriate care at the end of life. Experienced SPCTs are recognised to have higher referral rates compared to novice teams. The aim of this study was to assess the development of hospital-wide integration of specialist palliative care (PC) and of SPCTs in Dutch hospitals between 2014 and 2020.
Methods: Three cross-sectional surveys of SPCTs in Dutch hospitals were conducted in 2015, 2018 and 2021. Key members of the hospital SPCTs completed questionnaires about the preceding year that included items on hospital and PC program characteristics, hospital-wide integration of specialist PC, and SPCT characteristics (92 hospitals in 2015, 79 in 2018 and 74 in 2021). The analysis included hospitals with an operational SPCT, as determined by providing inpatient PC consultation services. Univariate analyses compared hospitals and SPCTs by year. Significance was determined by p-values < 0.05.
Results: In 2014, 65% of participating hospitals provided inpatient PC consultations (n = 48). This increased to 92% in 2017 (n = 58) and 98% in 2020 (n = 48). Over the years, participating hospitals showed an increasing level of hospital-wide integration of specialist PC, such as an increased number of dedicated PC outpatient clinics (56% in 2020, compared with 47% in 2017 and 27% in 2014). The annual number of inpatient referrals to SPCTs has increased significantly over the years. The SPCTs have developed significantly in various aspects, including collaboration between primary and hospital care, the availability of services to patients at home and non-clinical activities.
Conclusion: Over the years, Dutch hospitals have shown growth in hospital-wide integration of specialist PC. Specialist palliative care teams have made significant progress in increasing inpatient consultations, and in improving collaboration between primary and hospital care.
Competing Interests: Declarations. Ethics approval and consent to participate: This study involved organizations (hospitals) and no human subjects. Therefore, within the scope of the Dutch Medical Research Involving Human Subjects Act (WMO) and according to the Central Committee on Research involving Human Subjects (CCMO) this type of study is exempt from approval of an ethics committee. As the respondents were no research subjects themselves and solely provided organisational data, respondent participation in the survey was regarded as implicit consent. All respondents (i.e. key members of specialist palliative care teams or hospital palliative care program leaders) were informed that participation was anonymous and voluntary and withdrawal of the survey was possible at any time. All participants gave their informed consent by participating in the survey. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
(© 2025. The Author(s).)