Background: Terminal discharge is an emergent procedure for dying patients in hospital to return home. While reports on hospital staff experience exist, perspectives from community partners are lacking. Aim:We profile a cross section of decedent patients, and report clinician experience from a community hospice service.Design: A mixed-methods approach. Electronic medical records were analysed for characteristics, trajectories and service utilisation, comparing terminally discharged and regular

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... are patients over one year. Hospice care coordinators participated in an open-ended questionnaire and responses were analysed qualitatively. Settings/participants:The study was conducted in the largest home-based hospice service in Singapore. 260 referrals were received for terminal discharge in 2020, out of 3700 patients served. All five discharge coordinators responded to the questionnaire.Results:Only 228 of 260 terminally discharged patients reached home; 18 died before home visits could be made, and 10 outlived their prognoses. The ratio of cancer to non-cancer patients (1:1) in the terminal discharge group differed from the service's norm (4:1). Moreover, median length of service for this group (4 days) was 10 times shorter compared to decedents from regular service. This group also received on average three times higher service touchpoints (phone calls and home visits). Thematic analyses of survey responses revealed varying understanding of terminal discharge with concomitant implications; patchy handover between services that compromised care quality; and areas for improvement are suggested.Conclusions:Given its primacy and potential impact, active engagement of all stakeholders to optimise the management of terminal discharge is indicated.