I have to confess I am a fan of the New Zealand health system from across the ditch. Sensible spending. strong palliative care health service connections… am I wrong Bro?
This article has not succeeded in reversing my bias in favour of New Zealand.
Palliative data nerds will no doubt recall this fascinating study in Scotland by Professor Clark et al. Published in Palliative Medicine, and quickly attaining the journal’s highest-ever Altmetrics score (1) , Clark showed that among 10,743 inpatients in 25 Scottish teaching and general hospitals on 31 March 2010, 3,098 (28.8%) patients died during the one-year follow-up period. The findings were replicated in 2013 with similar results.
The study by the fabulous Professor Merryn Gott et al showed that on the same date, the corresponding figure in New Zealand (including obstetrics) was about half at 14.5%. Patients at higher risk of dying were the elderly of over 80 years of age, Maori, those with cancer, those from socially disadvantaged backgrounds, and those admitted under medical specialties rather than surgical.
New Zealand seems to provide better end of life care outside the hospital setting, with stronger end-of-life care in the aged care setting. This has certainly been a focus for service development in Australia as well.
How would we rate in Australia I wonder?
I would love to hear from international colleagues
Ref (1) https://www.gla.ac.uk/research/az/endoflifestudies/projects/imminence/
Sonia
palliverse.com 
Many thanks for highlighting our new paper and for a really interesting reflection on why you think there is such a big difference between end of life hospital use in NZ and Scotland. I think this is one for more general debate as we could only answer the ‘what’, not the ‘why’. It could be a good topic for a twitter chat? I’d love to engage the wider international palliative care community in thinking about the implications of the study.
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