BACKGROUND: Palliative care is associated with significant benefits, including reduced pain and suffering, an increased likelihood of patients dying in their preferred location, and decreased health-care expenditures. Racial and ethnic disparities are well-documented in hospice use and referral patterns; however, it is unclear whether these disparities apply to inpatient palliative care services. OBJECTIVE: To determine if race is a significant predictor of time to inpatient palliative care consult, patient enrollment in hospice, and patients' overall hospital length of stay among patients of an inpatient palliative care service. DESIGN: Retrospective noncomparative analysis. SETTING: Urban academic medical center in the United States. PATIENTS: 3207 patients referred to an inpatient palliative care service between March 2006 and April 2015. MEASUREMENTS: Time to palliative care consult, disposition of hospice/not hospice (excluding patients who died), and hospital length of stay among patients by racial (Asian, black, Native American/Eskimo, Hispanic, white, Unknown) and ethnic (Hispanic/Latino, non-Hispanic, Unknown) background. RESULTS: Race was not a significant predictor of time to inpatient palliative care consult, discharge to hospice, or hospital length of stay. Similarly, black/white, Hispanic/white, and Asian/white variables were not significant predictors of hospice enrollment ( Ps > .05). LIMITATIONS: Study was conducted at 1 urban academic medical center, limiting generalizability; hospital race and ethnicity categorizations may also limit interpretation of results. CONCLUSIONS: In this urban hospital, race was not a predictor of time to inpatient palliative care service consult, discharge to hospice, or hospital length of stay. Confirmatory studies of inpatient palliative care services in other institutions are needed.
BACKGROUND: Palliative care is associated with significant benefits, including reduced pain and suffering, an increased likelihood of patients dying in their preferred location, and decreased health-care expenditures. Racial and ethnic disparities are well-documented in hospice use and referral patterns; however, it is unclear whether these disparities apply to inpatient palliative care services. OBJECTIVE: To determine if race is a significant predictor of time to inpatient palliative care consult, patient enrollment in hospice, and patients' overall hospital length of stay among patients of an inpatient palliative care service. DESIGN: Retrospective noncomparative analysis. SETTING: Urban academic medical center in the United States. PATIENTS: 3207 patients referred to an inpatient palliative care service between March 2006 and April 2015. MEASUREMENTS: Time to palliative care consult, disposition of hospice/not hospice (excluding patients who died), and hospital length of stay among patients by racial (Asian, black, Native American/Eskimo, Hispanic, white, Unknown) and ethnic (Hispanic/Latino, non-Hispanic, Unknown) background. RESULTS: Race was not a significant predictor of time to inpatient palliative care consult, discharge to hospice, or hospital length of stay. Similarly, black/white, Hispanic/white, and Asian/white variables were not significant predictors of hospice enrollment ( Ps > .05). LIMITATIONS: Study was conducted at 1 urban academic medical center, limiting generalizability; hospital race and ethnicity categorizations may also limit interpretation of results. CONCLUSIONS: In this urban hospital, race was not a predictor of time to inpatient palliative care service consult, discharge to hospice, or hospital length of stay. Confirmatory studies of inpatient palliative care services in other institutions are needed.
Entities:
Keywords:
disparities; hospice care; inpatient palliative care; palliative care; palliative care consult; race and ethnicity; urban
Authors: Katie E Nelson; Rebecca Wright; Anna Peeler; Teresa Brockie; Patricia M Davidson Journal: Am J Hosp Palliat Care Date: 2021-01-11 Impact factor: 2.500
Authors: Katie E Nelson; Rebecca Wright; Marlena Fisher; Binu Koirala; Benjamin Roberts; Danetta H Sloan; David S Wu; Patricia M Davidson Journal: J Palliat Med Date: 2020-10-07 Impact factor: 2.947