Julia L Frydman1, Melissa Aldridge1,2, Jaison Moreno1, Joshua Singer3, Li Zeng1, Emily Chai1, R Sean Morrison1,2, Laura P Gelfman1,2. 1. Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 2. Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA. 3. Enterprise Reporting, Mount Sinai Health System, New York, New York, USA.
Abstract
Background: Palliative care (PC) services expanded rapidly to meet the needs of coronavirus disease 2019 (COVID-19) patients, yet little is known about which patients were referred for PC consultation during the pandemic. Objective: Examine factors predictive of PC consultation for COVID-19 patients. Design: Retrospective cohort study of COVID-19 patients discharged from four hospitals (March 1-June 30, 2020). Exposures: Patient demographic, socioeconomic, and clinical factors and hospital-level characteristics. Outcome Measurement: Inpatient PC consultation. Results: Of 4319 hospitalized COVID-19 patients, 581 (14%) received PC consultation. Increasing age, serious illness (cancer, chronic obstructive pulmonary disease, and dementia), greater illness severity, and admission to the quaternary hospital were associated with receipt of PC consultation. There was no association between PC consultation and race/ethnicity, household crowding, insurance status, or hospital-factors, including inpatient, emergency department, and intensive care unit census. Conclusions: Although site variation existed, the highest acuity patients were most likely to receive PC consultation without racial/ethnic or socioeconomic disparities.
Background: Palliative care (PC) services expanded rapidly to meet the needs of coronavirus disease 2019 (COVID-19) patients, yet little is known about which patients were referred for PC consultation during the pandemic. Objective: Examine factors predictive of PC consultation for COVID-19 patients. Design: Retrospective cohort study of COVID-19 patients discharged from four hospitals (March 1-June 30, 2020). Exposures: Patient demographic, socioeconomic, and clinical factors and hospital-level characteristics. Outcome Measurement: Inpatient PC consultation. Results: Of 4319 hospitalized COVID-19 patients, 581 (14%) received PC consultation. Increasing age, serious illness (cancer, chronic obstructive pulmonary disease, and dementia), greater illness severity, and admission to the quaternary hospital were associated with receipt of PC consultation. There was no association between PC consultation and race/ethnicity, household crowding, insurance status, or hospital-factors, including inpatient, emergency department, and intensive care unit census. Conclusions: Although site variation existed, the highest acuity patients were most likely to receive PC consultation without racial/ethnic or socioeconomic disparities.
Entities:
Keywords:
disparities in palliative care; hospitalized patients with COVID-19; inpatient palliative care consultation; pandemic palliative care
Authors: Nathan A Boucher; Mythili Raghavan; Alexander Smith; Robert Arnold; Kimberly S Johnson Journal: J Palliat Med Date: 2016-02 Impact factor: 2.947
Authors: C B Smith; J E Nelson; A R Berman; C A Powell; J Fleischman; J Salazar-Schicchi; J P Wisnivesky Journal: Ann Oncol Date: 2011-07-29 Impact factor: 32.976
Authors: William J Hall; Mimi V Chapman; Kent M Lee; Yesenia M Merino; Tainayah W Thomas; B Keith Payne; Eugenia Eng; Steven H Day; Tamera Coyne-Beasley Journal: Am J Public Health Date: 2015-10-15 Impact factor: 9.308
Authors: Kirsten Wentlandt; Monika K Krzyzanowska; Nadia Swami; Gary M Rodin; Lisa W Le; Camilla Zimmermann Journal: J Clin Oncol Date: 2012-10-29 Impact factor: 44.544
Authors: Alexander Supady; J Randall Curtis; Darryl Abrams; Roberto Lorusso; Thomas Bein; Joachim Boldt; Crystal E Brown; Daniel Duerschmied; Victoria Metaxa; Daniel Brodie Journal: Lancet Respir Med Date: 2021-01-12 Impact factor: 30.700
Authors: Theresa Tenge; Sebastian Brimah; Daniel Schlieper; Antje Roesel; Jacqueline Schwartz; Manuela Schallenburger; Stefan Meier; Timo Brandenburger; Detlef Kindgen-Milles; Peter Kienbaum; Martin Neukirchen Journal: J Clin Med Date: 2022-10-07 Impact factor: 4.964