BACKGROUND: The VA Puget Sound Health Care System (VAPSHCS) started a palliative care service (PCS) in October 2001 to provide case management for patients with advanced cancer. OBJECTIVE: To examine resource use during the last 60 days of life for patients dying of cancer who received PCS compared to patients receiving usual care (non-PCS) during the same time period. DESIGN: Retrospective nonrandomized comparison of resource use using administrative data. SETTING: Tertiary care Veterans Affairs medical center. PARTICIPANTS: All patients who died of cancer between October 1, 2001 and October 31, 2002 at VAPSHCS. RESULTS: Two hundred sixty-five patients died of cancer during the specified time period, including 82 PCS and 183 non-PCS patients. PCS patients received case management for a mean of 79 days, and were younger, had more comorbid conditions, and were more likely to have had chemotherapy in the last 60 days of life than non-PCS patients. Variables associated with more acute care bed days in the last 60 days of life included: chemotherapy in the last 60 days of life, and a length of stay on PCS less than 60 days. Variables associated with fewer acute care bed days within the last 60 days of life included: being married, and a length of stay on PCS 60 days or more. Compared to non-PCS patients, the place of death for PCS patients was less likely to be acute care. CONCLUSION: PCS for 60 or more days prior to death was associated with decreased use of acute care hospital resources for patients dying of cancer.
BACKGROUND: The VA Puget Sound Health Care System (VAPSHCS) started a palliative care service (PCS) in October 2001 to provide case management for patients with advanced cancer. OBJECTIVE: To examine resource use during the last 60 days of life for patients dying of cancer who received PCS compared to patients receiving usual care (non-PCS) during the same time period. DESIGN: Retrospective nonrandomized comparison of resource use using administrative data. SETTING: Tertiary care Veterans Affairs medical center. PARTICIPANTS: All patients who died of cancer between October 1, 2001 and October 31, 2002 at VAPSHCS. RESULTS: Two hundred sixty-five patients died of cancer during the specified time period, including 82 PCS and 183 non-PCSpatients. PCSpatients received case management for a mean of 79 days, and were younger, had more comorbid conditions, and were more likely to have had chemotherapy in the last 60 days of life than non-PCSpatients. Variables associated with more acute care bed days in the last 60 days of life included: chemotherapy in the last 60 days of life, and a length of stay on PCS less than 60 days. Variables associated with fewer acute care bed days within the last 60 days of life included: being married, and a length of stay on PCS 60 days or more. Compared to non-PCSpatients, the place of death for PCSpatients was less likely to be acute care. CONCLUSION:PCS for 60 or more days prior to death was associated with decreased use of acute care hospital resources for patients dying of cancer.
Authors: Shannon M Dunlay; Margaret M Redfield; Ruoxiang Jiang; Susan A Weston; Véronique L Roger Journal: Circ Heart Fail Date: 2015-04-01 Impact factor: 8.790
Authors: Daniel P Triplett; Wendi G LeBrett; Alex K Bryant; Andrew R Bruggeman; Rayna K Matsuno; Lindsay Hwang; Isabel J Boero; Eric J Roeland; Heidi N Yeung; James D Murphy Journal: J Oncol Pract Date: 2017-08-22 Impact factor: 3.840
Authors: Melissa D A Carlson; Jeph Herrin; Qingling Du; Andrew J Epstein; Colleen L Barry; R Sean Morrison; Anthony L Back; Elizabeth H Bradley Journal: J Clin Oncol Date: 2010-08-30 Impact factor: 44.544