Palliative care service use by older people : time trends from a mortality follow-back study between 2005 and 2014

Background: The need for increased use and timely initiation of palliative care for all people, not just those who die with cancer, has been advocated worldwide over the past decade. Aim: To investigate whether there has been a time trend in the use of palliative care services and the timing of their initiation for older people. Design: Mortality follow-back survey among general practitioners in a nationally representative Sentinel Network in 2005-2010, 2013 and 2014 in Belgium. Setting/participants: Of all their patients who died non-suddenly aged 65+years, general practitioners reported sociodemographic and clinical data, use of any of the palliative care services available in Belgium and when the first of these services was initiated. Results: General practitioners identified 5344 deaths. Overall, palliative care service use increased from 39% in 2005 to 63% in 2014 (p<0.001). The use of a reference person for palliative care in a care home increased from 12% to 26% (p<0.001) and of a palliative homecare team from 14% to 17.5% (p