Describing the Uniquely Vulnerable Patients Served by an Outpatient Non-Oncologic Palliative Clinic.

Abstract

Context: Outpatient nononcologic palliative care is a growing field with an evolving identity.

Objectives: The objective of this study was to assess patient demographics and clinical utilization of an outpatient nononcologic palliative care clinic.

Methods: We collected and analyzed data from the first two years of an urban, nononcologic palliative care clinic within a quaternary academic center.

Results: The diagnoses with highest clinic utilization were heart failure (46.2%) and end-stage lung disease (16.6%). The medical complexity of these patients was high, with geriatric patients comprising 55% of the clinic population and 95.3% of patients meeting criteria for polypharmacy. Insurance data demonstrated a socially vulnerable population served with 65.6% of patients on a Medicare product, 36.7% on a Medicaid product, and 4.7% uninsured. 21.3% of new clinic visits were for medical cannabis certification. Patients elected for telehealth visits more often than age matched patients in the general primary care setting and were less likely to no-show to telehealth visits. Primary diagnosis impacted frequency of follow up, with patients with end stage lung disease returning more regularly than patients with heart failure.

Conclusion: Nononcologic palliative care serves a uniquely medical vulnerable population and can be supported through utilization of clinical infrastructure that is already in place, establishing multidisciplinary collaborations, and utilizing telehealth.