The American journal of hospice & palliative care最新文献_第5页

"Are They Just Experimenting With All of Us?" Cultural Considerations for Clinicians Caring for Seriously Ill Great Plains American Indians.

The American journal of hospice & palliative care Pub Date : 2025-03-14 DOI: 10.1177/10499091251327404

Bethany-Rose Daubman, Tinka Duran, Gina Johnson, Alexander Soltoff, Sara J Purvis, Leroy J R LaPlante, Sean Jackson, Daniel Petereit, Matthew Tobey, Katrina Armstrong, Mary J Isaacson

{"title":"\"Are They Just Experimenting With All of Us?\" Cultural Considerations for Clinicians Caring for Seriously Ill Great Plains American Indians.","authors":"Bethany-Rose Daubman, Tinka Duran, Gina Johnson, Alexander Soltoff, Sara J Purvis, Leroy J R LaPlante, Sean Jackson, Daniel Petereit, Matthew Tobey, Katrina Armstrong, Mary J Isaacson","doi":"10.1177/10499091251327404","DOIUrl":"https://doi.org/10.1177/10499091251327404","url":null,"abstract":"Context: Serious illnesses like cancer disproportionately affect American Indians and Alaska Native (AI/AN) Peoples. AI/AN patients deserve culturally responsive healthcare at all times, and especially when journeying through serious illness. Objectives: To learn about specific clinician-related factors that AI/AN cancer survivors, caregivers, Tribal leaders, and traditional healers want from their clinicians while experiencing cancer. Methods: We utilized qualitative interviews and Indigenous talking circles to explore perspectives on what type of clinician education, communication approaches, and clinical resources are desired so that clinicians may provide culturally responsive care to AI/AN peoples experiencing cancer. Analysis was completed via a team of Native and non-Native researchers analyzing narrative data from AI/AN cancer survivors, caregivers, Tribal leaders, and traditional healers. Results: Interviews and talking circle qualitative analysis revealed 3 major themes related to clinician needs: cultural considerations, psychosocial support, and trust. Conclusion: Any clinician caring for AI/AN peoples with serious illness such as cancer needs to understand clinician-related factors that AI/ANs say impact their care when experiencing serious illness. It is important for clinicians to engage in cultural education and work to improve systemic deficiencies such as a lack of psychosocial support. An overarching theme was also the need for clinicians to seek to develop trustworthiness and earn trust when caring for AI/AN patients experiencing serious illness.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251327404"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

You've Got A Friendtor in Me: Innovations in Peer Mentoring for Mid-Career Palliative Care Clinicians.

The American journal of hospice & palliative care Pub Date : 2025-03-14 DOI: 10.1177/10499091251327378

April Zehm, Andrew J Lawton, Leah B Rosenberg, Sudha Natarajan, Bethany-Rose Daubman

{"title":"You've Got A Friendtor in Me: Innovations in Peer Mentoring for Mid-Career Palliative Care Clinicians.","authors":"April Zehm, Andrew J Lawton, Leah B Rosenberg, Sudha Natarajan, Bethany-Rose Daubman","doi":"10.1177/10499091251327378","DOIUrl":"https://doi.org/10.1177/10499091251327378","url":null,"abstract":"Introduction: Mentoring is crucial to professional success, but little is known about the professional development needs of mid-career hospice and palliative medicine (HPM) clinicians. Methods: An interprofessional \"friendtor\" group of five HPM clinicians from three academic medical centers met monthly and for a year-end focus group. A thematic analysis was used to develop a coding structure and identify overarching themes from these discussions. Results: Several themes emerged that highlight the importance of peer support when navigating major life decisions, boundary-setting, and non-clinical practice challenges, celebrating friendtors' personal and professional milestones, and having a productive space for shared academic pursuits. Discussion: Given the challenges and vulnerabilities the field of HPM is experiencing with workforce sustainability and burnout, the importance of developing supports outside of traditional mentorship paradigms is a valuable area of focus. Our work suggests that a friendtorship model may be an effective tool for sustaining mid-career HPM clinicians.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251327378"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Consistent, Concise and Meaningful: Clinician Perceptions of a Novel Dyspnea Assessment Tool.

The American journal of hospice & palliative care Pub Date : 2025-03-14 DOI: 10.1177/10499091251325566

Meena Kalluri, Charlotte Pooler

{"title":"Consistent, Concise and Meaningful: Clinician Perceptions of a Novel Dyspnea Assessment Tool.","authors":"Meena Kalluri, Charlotte Pooler","doi":"10.1177/10499091251325566","DOIUrl":"https://doi.org/10.1177/10499091251325566","url":null,"abstract":"BackgroundDyspnea is a prevalent and distressing symptom in interstitial lung diseases with significant effects on patients' quality of life and associated with poorer prognosis. Guidelines recommend a multidimensional dyspnea assessment tool. We developed a validated 9-item scale, the Edmonton Dyspnea Inventory (EDI), in which dyspnea severity is rated across different settings including at rest, during activities of daily living, and self-reported exercise and crises. The standardized, multidimensional tool captures dyspnea intensity for specific contexts, which clinicians can use to manage dyspnea more individually and effectively. Early studies support the feasibility to use the EDI in outpatient settings. The purpose of this study was to explore perceptions of the EDI by community health care professionals.MethodsWe conducted a qualitative study using an inductive approach and open coding for content analysis. Email invitations were sent to community health care professionals and informed consent obtained from the twelve participants. Two focus groups and one key informant interview were conducted. Themes were extracted from transcripts and field note analyses.ResultsFour main themes described their dyspnea assessment with the EDI: the EDI is a meaningful clinical assessment tool; they explicitly engage and educate patients to effectively use the EDI; they use the EDI to personalize and evaluate dyspnea management; and the EDI is valuable for communication and interprofessional collaboration.ConclusionCommunity health care professionals perceived the EDI as valuable to assess dyspnea and personalize management. They recommended it be used in clinical practice and healthcare education for interprofessional dyspnea management for ILD patients.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251325566"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advance Care Planning in the Inpatient Setting: The Role of the Hospitalist. 住院环境中的预先护理规划：住院医生的角色。

The American journal of hospice & palliative care Pub Date : 2025-03-14 DOI: 10.1177/10499091251326184

Nikhil Sood, Rohini Garg, Anthony D Slonim

{"title":"Advance Care Planning in the Inpatient Setting: The Role of the Hospitalist.","authors":"Nikhil Sood, Rohini Garg, Anthony D Slonim","doi":"10.1177/10499091251326184","DOIUrl":"https://doi.org/10.1177/10499091251326184","url":null,"abstract":"Advance care planning (ACP) is critical to patient-centered health care, particularly in hospital settings where acute and end-of-life decisions often occur. As frontline providers, hospitalists are uniquely positioned to initiate and guide ACP discussions. This article explores the role of hospitalists in ACP, identifies barriers to its implementation, and highlights strategies to overcome these challenges. Key barriers include time constraints, lack of formal training, and uncertainty regarding the appropriate timing of discussions. To address these issues, hospitalists can benefit from structured communication training, integration of ACP prompts into electronic health records, and collaboration with multidisciplinary teams. While ACP has demonstrated benefits, including the alignment of care with patient preferences, reduced unnecessary interventions, and improved satisfaction for patients and families, challenges remain in ensuring consistent and culturally sensitive implementation. This article also examines the ongoing debate regarding the advantages of ACP, balancing its potential to enhance care with concerns about emotional discomfort and operational barriers. Ultimately, ACP represents a pivotal opportunity to advance patient autonomy and deliver compassionate care. By addressing barriers and leveraging institutional and policy-level support, hospitalists can lead the charge in making ACP a standard and meaningful aspect of health care delivery.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251326184"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Knowledge of and Attitudes Towards End-of-Life Doulas Among Gynecologic Oncologists.

The American journal of hospice & palliative care Pub Date : 2025-03-12 DOI: 10.1177/10499091251326093

Gabriela Weigel, Corinne Jansen, Chioma Anaemejeh, Rachel Flink-Bochacki, Katherine Miller, Benjamin Margolis

{"title":"Knowledge of and Attitudes Towards End-of-Life Doulas Among Gynecologic Oncologists.","authors":"Gabriela Weigel, Corinne Jansen, Chioma Anaemejeh, Rachel Flink-Bochacki, Katherine Miller, Benjamin Margolis","doi":"10.1177/10499091251326093","DOIUrl":"https://doi.org/10.1177/10499091251326093","url":null,"abstract":"ObjectiveEnd-of-life doulas (EOLDs) offer non-medical support to patients and families, yet little is known regarding how knowledgeable and receptive gynecologic oncologists are to EOLDs.MethodsMembers of the New England Association of Gynecologic Oncologists (NEAGO) were surveyed regarding demographics and familiarity with and attitudes towards EOLDs. Descriptive statistics described demographics. Chi-square testing and Spearman's correlation coefficient were used for comparative analysis.ResultsThirty-nine of 85 NEAGO members completed the survey (response rate 46%). Most were physician gynecologic oncologists (95%) who practiced in academic settings (79%) and participated in end-of-life care (92%). Thirty-nine percent had heard of an EOLD. One clinician had a patient or family request EOLD services, but no one had personally worked with an EOLD. No one was familiar with the cost of EOLDs. After reading information regarding EOLDs, most agreed that EOLDs could be a valuable component of end-of-life care (87%) and they should be accessible and affordable to patients (85%). A majority reported they would be likely to recommend an EOLD to patients during the dying period (62%). A positive correlation was found between those who perceived EOLDs as valuable and their likelihood to recommend EOLDs to patients (rs = 0.6, P < 0.001). Younger clinicians and those with fewer years of practice were also more likely to recommend EOLDs to patients.ConclusionKnowledge of and experience with EOLDs is limited among surveyed gynecologic oncologists. After education on their roles, many clinicians see value in their services and would recommend EOLDs to their patients.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251326093"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Doctor Facilitated Denial: A Barrier to Advance Care Planning Among COPD Patients.

The American journal of hospice & palliative care Pub Date : 2025-03-04 DOI: 10.1177/10499091251325800

Lauren Seidman, Negin Hajizadeh

{"title":"Doctor Facilitated Denial: A Barrier to Advance Care Planning Among COPD Patients.","authors":"Lauren Seidman, Negin Hajizadeh","doi":"10.1177/10499091251325800","DOIUrl":"https://doi.org/10.1177/10499091251325800","url":null,"abstract":"Background: Many severe COPD patients are unaware of their treatment options and lack motivation for advance care planning. It is crucial to increase patient awareness regarding their chronic conditions.Methods: The InformedTogether decision aid was used in outpatient clinical visits to inform patients about their COPD prognosis. Audio-recorded visits were analyzed for how denial, self-perceived health, and trust impacted patient motivation to make an advance care plan.Results: Of the 26 patients, 4 (15.38%) showed an increase in motivation, 20 (76.92%) had no change, and 2 (7.69%) showed a decrease in motivation. Denial facilitated by physicians did not significantly affect motivation (p = 0.543). Self-perceived health also had no significant impact on motivation, with 68.00% rating their health as poor, 16.00% as fair, and 16.00% as good (p = 0.847). Trust in the physician's information was generally high, with 64.00% reporting high trust, but did not lead to an increase in motivation (p = 0.512).Conclusion: Denial, self-perceived health, and trust did not significantly affect patient motivation to make an advance care plan. This study suggests that barriers to increasing motivation remain, and further research on external factors may be helpful to improve patient participation in end-of-life care planning.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251325800"},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Analysis of Hospice Trends in the United States in 2020 Among Medicare Beneficiaries.

The American journal of hospice & palliative care Pub Date : 2025-03-03 DOI: 10.1177/10499091251324517

Noor Chughtai, Cortland Brown, Jordan Shelestak, Jared Nichols

{"title":"The Analysis of Hospice Trends in the United States in 2020 Among Medicare Beneficiaries.","authors":"Noor Chughtai, Cortland Brown, Jordan Shelestak, Jared Nichols","doi":"10.1177/10499091251324517","DOIUrl":"https://doi.org/10.1177/10499091251324517","url":null,"abstract":"Hospice care plays a critical role in the healthcare system, providing terminally ill patients comfort and symptom management. While hospice care has many benefits, there is variability among the service throughout the United States. This study examines variations in the average length of hospice care among Medicare beneficiaries, specifically focusing on how geographic location and primary diagnoses influence these outcomes. Through analyzing these differences, this research aims to identify potential disparities in hospice care and influence positive change in end-of-life care. Public hospice care data from data.cms.gov were analyzed to explore these trends. Findings indicate that Medicare beneficiaries in the South and West regions of the U.S. experience longer hospice stays, and in contrast, those in the Northeast and Midwest (including Alaska) reflected reduction from this average. Notably, states with shorter hospice durations showed a higher proportion of neoplastic disorders as the primary diagnosis, while those with longer stays showed an inverse relationship with greater prevalence of circulatory system disorders and lower incidence of neoplastic diagnoses. Additionally, the analysis reveals a consistent decline in average hospice length with increasing age among patients aged 80-85 across all U.S. regions, as expected. These findings highlight regional and diagnostic factors that contribute to variations in hospice care duration. Ultimately, this study highlights the need for comprehensive patient data and qualitative research to better address the disparities in end-of-life care delivery.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091251324517"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Implementing Serious Illness Conversations Across a Comprehensive Cancer Center Using an Interdisciplinary Approach. 综合癌症中心采用跨学科方法开展重病对话的影响。

The American journal of hospice & palliative care Pub Date : 2025-03-01 Epub Date: 2024-05-10 DOI: 10.1177/10499091241252058

Karen Guo, Garrett Wasp, Maxwell Vergo, Matthew Wilson, Megan M Holthoff, Madge E Buus-Frank, James J Perry, Amelia M Cullinan

{"title":"Impact of Implementing Serious Illness Conversations Across a Comprehensive Cancer Center Using an Interdisciplinary Approach.","authors":"Karen Guo, Garrett Wasp, Maxwell Vergo, Matthew Wilson, Megan M Holthoff, Madge E Buus-Frank, James J Perry, Amelia M Cullinan","doi":"10.1177/10499091241252058","DOIUrl":"10.1177/10499091241252058","url":null,"abstract":"Background: Gaps in communication of end-of-life care preferences increase risk of patient harm. Adoption of oncology practice guidelines advocating serious illness communication for patients with advanced cancer is limited.Objectives: (1) Increase Serious Illness Conversation (SIC) use across oncology teams via an interdisciplinary quality improvement (QI) approach and (2) assess patient reported shared decision making (SDM) experiences with clinicians engaged in SIC implementation.Design: QI methodology was applied to spread the implementation of SIC across 4 oncology teams. CollaboRATE scores were used to evaluate patient reported outcomes of SDM for patients with advanced cancer.Settings/subjects: The SIC QI initiative was a component of the Promise Partnership Learning Health System (PPLHS) piloted in the Dartmouth Cancer Center, Lebanon, NH, USA.Measurements: (1) The percentage of eligible patients with documented SIC and (2) a comparison of a patient reported measure of SDM (CollaboRATE) among SIC eligible patients in encounters with providers who took part in the implementation versus those who did not.Results: Oncology teams screened a total of 538 patients, identified 278 eligible patients, and completed 144 SIC conversations. The teams improved the proportion of documented SIC among eligible patients from near 0% to a collective frequency of 52%. For clinicians' top-box CollaboRATE scores, a chi-squared test demonstrated a statistically significant association between providers implementing SIC into practice and patient reported shared decision making (.16, p = .031).Conclusions: This approach allows for tailoring of iterative improvement cycles to mitigate barriers and improve the practice of SIC among oncology teams.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"253-260"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patterns of Palliative Care Consultation in Neurosurgical Patients. 神经外科患者的姑息治疗咨询模式。

The American journal of hospice & palliative care Pub Date : 2025-03-01 Epub Date: 2024-05-17 DOI: 10.1177/10499091241255349

Sawyer Kieffer, John Arce, Amy Ogilvie, Hiroyuki Oya, Yuya Hagiwara

{"title":"Patterns of Palliative Care Consultation in Neurosurgical Patients.","authors":"Sawyer Kieffer, John Arce, Amy Ogilvie, Hiroyuki Oya, Yuya Hagiwara","doi":"10.1177/10499091241255349","DOIUrl":"10.1177/10499091241255349","url":null,"abstract":"Numerous neurosurgical (NSG) conditions entail high morbidity, mortality, and prolonged ICU stays. Palliative care (PC) serves to alleviate suffering, align treatment with patient preferences, and is linked to enhanced patient and family outcomes as well as reduced care costs. Notably, no studies have addressed demographic and clinical factors associated with PC receipt in NSG patients. Our aim is to identify characteristics and outcomes, particularly end of life outcomes, of hospitalized NSG patients associated with a PC consult compared with usual NSG care. A retrospective chart review was performed of patients admitted to the NSG service from January 1, 2017 to December 31, 2018 at the University of Iowa Hospitals & Clinics. Data regarding demographics, clinical outcomes, and GOC and ACP documentation were collected. The most common reasons for a PC consult were goals of care, end of life issues, and comfort care. Of 121 total decedent patients, 97 (80.2%) had PC referrals. Patients with a PC referral had longer hospital stays (10.3 days vs 4 days) and had the majority of care in the ICU (90.7% vs 83.3%). However, fewer PC patients died in the ICU (42.3% vs 75%) and more had PCA/NCA use (51.5% vs 8.3%), code status changes to DNR (90.7% vs 62.5%), GOC documented (78.4% vs 0%) and ACP documentation (35.1% vs 16.7%). In conclusion, in NSG patients, the integration of PC may contribute to improved end-of-life care.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"282-286"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inpatient Palliative Care and Healthcare Utilization Among Older Patients With Alzheimer's Disease and Related Dementia (ADRD) and High Risk of Mortality in U.S. Hospitals. 美国医院中阿尔茨海默病及相关痴呆症 (ADRD) 和高死亡率风险老年患者的住院姑息治疗和医疗服务使用情况。

The American journal of hospice & palliative care Pub Date : 2025-03-01 Epub Date: 2024-05-06 DOI: 10.1177/10499091241252685

Zhigang Xie, Guanming Chen, Oluwadamilola T Oladeru, Hanadi Y Hamadi, Lucinda Montgomery, Maisha T Robinson, Young-Rock Hong

{"title":"Inpatient Palliative Care and Healthcare Utilization Among Older Patients With Alzheimer's Disease and Related Dementia (ADRD) and High Risk of Mortality in U.S. Hospitals.","authors":"Zhigang Xie, Guanming Chen, Oluwadamilola T Oladeru, Hanadi Y Hamadi, Lucinda Montgomery, Maisha T Robinson, Young-Rock Hong","doi":"10.1177/10499091241252685","DOIUrl":"10.1177/10499091241252685","url":null,"abstract":"Background. Despite the potential of palliative care (PC) to enhance the quality of life for patients with advanced dementia, there is limited knowledge of its inpatient utilization patterns. This study investigated inpatient PC consultation utilization patterns and evaluated its impact on hospital length of stay (LOS) and medical costs among older patients diagnosed with Alzheimer's Disease and Related Dementia who were at a high risk of mortality (ADRD-HRM). Methods. Using the 2016-2019 National Inpatient Sample database, we conducted multivariable logistic regression analyses to identify individual and hospital characteristics influencing PC consultation utilization. We subsequently performed generalized linear models to estimate LOS (using Poisson distribution) and hospital charges (via log-transformation). Results. Our sample encompassed 965,644 hospital discharges (weighted n = 4,828,219) of patients aged 65 years and above with ADRD-HRM. Among them, 14.6% received inpatient PC. There was a notable uptrend in PC consultation utilization from 13.3% in 2016 to 16.3% in 2019 (p trend<.001). Factors positively influencing and associated with PC utilization included patients that are older, non-Hispanic White, with higher income, receiving care from teaching hospitals, and facilitated with greater bed capacity (all P < .05). Although patients who received PC were more likely to have 3.0% longer LOS (P < .001), they had 19.2% lower hospital charges (P < .001). Conclusions. PC substantially reduced hospital expenditures for older patients with ADRD-HRM, but the prevalence remained low at 14.6% in the study period. Future studies should explore the unmet needs of patients with lower sociodemographic status and those in rural hospitals to further increase their PC consultation utilization.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"261-272"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0