Outcomes and Determinants of Good Death Among End-of-Life Patients Receiving Palliative Care Services at Sawanpracharak Hospital

Abstract

Thailand is entering a fully aged society, making end-of-life care increasingly important. Although the concept of a “good death” has been recognized as a key indicator of quality care, there remains a lack of outcome-based evidence in hospital settings to guide service development. This study aimed to evaluate the quality of end-of-life care using good death indicators and to identify factors associated with these outcomes.

This research employed a retrospective analytical descriptive design. Data were collected from 398 terminally ill patients who died under the palliative care service system at Sawanpracharak Hospital during fiscal years 2024 – 2025. Statistical analyses included descriptive statistics, Chi-square test, and logistic regression.

The results showed that the overall rate of achieving a good death was high at 98.20%. The proportion of home deaths increased significantly from 49.07% in 2024 to 61.00% in 2025 (P-value = 0.026). In the analysis of associated factors, non-cancer patients were less likely to achieve a good death compared to cancer patients (adjusted OR = 0.22, 95% CI = 0.05–1.01, P-value = 0.051). Other factors were not significantly associated with the outcome.

These findings reflect the overall quality of the palliative care service system while highlighting challenges in providing end-of-life care for non-cancer patients. This evidence can be used to inform the development of more equitable and high-quality palliative care services in the future.