| Summary: | Objectives There is an acute unmet need for specialist palliative care services in Residential Aged Care Homes (RACHs). Palliative care needs rounds (Needs Rounds) are a promising evidence-based outreach approach to improve access to specialist care for this population. This study aimed to evaluate the feasibility and cost effectiveness of implementing needs rounds across a metropolitan Australian health service. Methods A retrospective pre–post cohort study was conducted comparing outcomes from May–October 2021 with the same period in 2019. Primary outcomes were emergency department (ED) presentations and hospital admissions among RACH residents. Secondary outcomes included estimated cost savings and released hospital capacity. Analyses were conducted from the perspective of the public health service provider. Findings are descriptive, and no formal statistical hypothesis testing was undertaken. Results Needs rounds were implemented in 39 of 56 RACHs (70%) within the first nine months. Facilities not participating were primarily affected by operational constraints, including staffing pressures and pandemic-related disruptions. Compared with 2019, ED presentations declined by 20% and hospital admissions by 64%. Estimated cost savings associated with reduced hospital utilization were AU$498,315 per month. These findings should be interpreted cautiously given concurrent system-wide changes associated with the COVID-19 pandemic. Conclusion Needs rounds appear feasible to implement at scale and may reduce hospital utilization among RACH residents. Preliminary economic findings suggest potential cost savings and released capacity within the health system. However, causal attribution remains uncertain, and full implementation costs were not captured. Further controlled studies incorporating patient-centred outcomes are required.
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