Steven M Albert1, June R Lunney2, Lei Ye3, Robert Boudreau3, Diane Ives3, Suzanne Satterfield4, Cameron M Kaplan4, Teresa Waters4, Hilsa N Ayonayon5, Susan M Rubin5, Anne B Newman3, Tamara Harris6. 1. Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania. 2. Hospital and Palliative Nursing Association, Pittsburgh, Pennsylvania. 3. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania. 4. Department of Preventive Medicine, University of Tennessee, Memphis, Tennessee. 5. Department of Epidemiology and Biostatistics, University of California, San Francisco, California. 6. Laboratory of Epidemiology, Biometry, and Demography, National Institute on Aging, Bethesda, Maryland.
Abstract
Objectives: To examine the relationship between end-of-life (EOL) treatment preferences and recent hospitalization or emergency department (ED) care in the very old. Design: Quarterly telephone follow-up of participants in the EOL in the Very Old cohort. Setting: The EOL in the Very Old Age cohort drew from 1403 participants in the Health, Aging, and Body Composition (Health ABC) study who were alive in year 15 of follow-up. 87.5% (n = 1227) were successfully recontacted and enrolled. Participants: Preferences for treatment at the EOL and reported hospital and ED use were examined for 1118 participants (18% involving proxy reports) over 6 months, 1021 (16% with proxy reports) over 12 months, and 945 (23% with proxy reports) over 18 months in 6-month intervals. Measurements: Preferences for eight EOL treatments, elicited once each year; hospitalization and ED use reported every six months. Results: Preferences for more aggressive treatment (endorsing ≥5 of 8 options) were not significantly associated with inpatient or ED treatment. Inpatient and ED treatment were not associated with changes in preferences for aggressive EOL treatment over 12 months. Conclusion: Alternative measures that tap attitudes toward routine care, rather than EOL treatment preferences, may be more highly associated with healthcare utilization.
Objectives: To examine the relationship between end-of-life (EOL) treatment preferences and recent hospitalization or emergency department (ED) care in the very old. Design: Quarterly telephone follow-up of participants in the EOL in the Very Old cohort. Setting: The EOL in the Very Old Age cohort drew from 1403 participants in the Health, Aging, and Body Composition (Health ABC) study who were alive in year 15 of follow-up. 87.5% (n = 1227) were successfully recontacted and enrolled. Participants: Preferences for treatment at the EOL and reported hospital and ED use were examined for 1118 participants (18% involving proxy reports) over 6 months, 1021 (16% with proxy reports) over 12 months, and 945 (23% with proxy reports) over 18 months in 6-month intervals. Measurements: Preferences for eight EOL treatments, elicited once each year; hospitalization and ED use reported every six months. Results: Preferences for more aggressive treatment (endorsing ≥5 of 8 options) were not significantly associated with inpatient or ED treatment. Inpatient and ED treatment were not associated with changes in preferences for aggressive EOL treatment over 12 months. Conclusion: Alternative measures that tap attitudes toward routine care, rather than EOL treatment preferences, may be more highly associated with healthcare utilization.
Entities:
Keywords:
Health ABC; cohort studies; end-of-life; healthcare utilization; treatment preferences
Authors: Catherine L Auriemma; Christina A Nguyen; Rachel Bronheim; Saida Kent; Shrivatsa Nadiger; Dustin Pardo; Scott D Halpern Journal: JAMA Intern Med Date: 2014-07 Impact factor: 21.873
Authors: Daren K Heyland; Doris Barwich; Deb Pichora; Peter Dodek; Francois Lamontagne; John J You; Carolyn Tayler; Pat Porterfield; Tasnim Sinuff; Jessica Simon Journal: JAMA Intern Med Date: 2013-05-13 Impact factor: 21.873
Authors: Susan E Hickman; Christine A Nelson; Alvin H Moss; Susan W Tolle; Nancy A Perrin; Bernard J Hammes Journal: J Am Geriatr Soc Date: 2011-10-22 Impact factor: 5.562
Authors: Kenneth Chambaere; Judith A C Rietjens; Joachim Cohen; Koen Pardon; Reginald Deschepper; H Roeline W Pasman; Luc Deliens Journal: BMC Public Health Date: 2013-11-09 Impact factor: 3.295