Life-Sustaining Procedures, Palliative Care, and Cost Trends in Dying COPD Patients in U.S. Hospitals: 2005~2014

Kim, Sun Jung; Shen, Jay J.; Ko, Eunjeong; Kim, Pearl; Lee, Yong-Jae; Lee, Jae Hoon; Liu, Xibei; Ukken, Johnson; Kioka, Mutsumi; Yoo, Ji Won

doi:10.14475/kjhpc.2018.21.1.23

Cited by 3 publications

(5 citation statements)

References 42 publications

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“…Metastatic breast cancer patients that received palliative care increased by 7.6% from 2010 to 2014. The increased utilization of palliative care from year-to-year among metastatic breast cancer patients was consistent with previous American studies on the utilization of palliative care in patients with other medical issues such as chronic obstructive pulmonary disease (COPD) 29 , multiple sclerosis 30 29 . The percentage of patients with multiple sclerosis who received palliative care increased from 0.2% in 2005 to 6.1% in 2014 30 .…”

Section: Discussionsupporting

confidence: 87%

“…This study also showed that receiving palliative care was associated with lower in-hospital mortality (OR = 6.59), which is consistent with previous studies on different cancers and conditions 11,30 , where palliative care is more likely recommended to patients who are terminally ill or as a last resort 11 . Palliative care has proven to be beneficial for patients with earlier-stage cancers or in combination with traditional treatment 11,29,30 . Many studies regarding this topic show that palliative care is commonly reserved for the elderly.…”

Section: Discussionmentioning

confidence: 99%

“…COPD patients receiving palliative care experienced a 28.7% decrease in hospital charges, compared to those who did not. Palliative care that is introduced sooner and used in conjunction with treatment has been shown to improve health outcomes and lower hospital charges when compared to palliative care that is introduced later 29 . A study on the use of palliative care in children found that using palliative care was associated with significantly lower overall and daily hospital costs 40 .…”

Section: Discussionmentioning

confidence: 99%

“…Hospital attributes included information concerning teaching status, location, and bed-size. We defined our variables based on previous literatures using NIS samples 23,28,29 .…”

Section: Variablesmentioning

confidence: 99%

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Palliative care and healthcare utilization among metastatic breast cancer patients in U.S. Hospitals

Kim

Patel

Park³

et al. 2023

Sci Rep

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There is a lack of research focused on understanding the different characteristics and healthcare utilization of metastatic breast cancer patients by palliative care use. This study aims to investigate trend of in-patient palliative care and its association with healthcare utilization among hospitalized metastatic breast cancer patients in the US. National Inpatient Sample (NIS) was used to identify nationwide metastatic breast cancer patients (n = 5209, weighted n = 25,961) from 2010 to 2014. We examined the characteristics of the study sample by palliative care and its association with healthcare utilization, measured by discounted hospital charges and length of stay. Multivariable survey regression models were used to identify predictors. Among 26,961 breast cancer patients, 19.0% had palliative care. Percentage of receiving palliative care during the period were gradually increased. Social factors including race, insurance types were also associated with a receipt of palliative care. Survey linear regression results showed that patients with palliative care were associated with 31% lower hospital charges, however, length of stays were not significantly associated. This study found evidence of who was associated with the receipt of palliative care and its relationship with healthcare utilization. This study also emphasizes the importance of receiving palliative care in patients with breast cancer, paving the way for future research into ways to improve palliative care in cancer patients. This study also found social differences and gave evidence of programs that could be used to help vulnerable groups in future health policy decisions.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Hospital attributes included information concerning teaching status, location, and bed-size. We defined our variables based on previous literatures using NIS samples 23,28,29 .…”

Section: Variablesmentioning

confidence: 99%

See 2 more Smart Citations

Palliative care and healthcare utilization among metastatic breast cancer patients in U.S. Hospitals

Kim

Patel

Park³

et al. 2023

Sci Rep

Self Cite

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“…For instance, a study reported an increase of 0.45% to 2.56% between 2006 and 2012 among end-stage chronic obstructive pulmonary disease patients [ 22 ]. Another study using the National Inpatient Sample reported that chronic obstructive pulmonary disease patients receiving palliative care increased from 8.5% to 57.2% between 2005 and 2014 [ 23 ]. In studies using cancer patients, similar trends were also reported.…”

Section: Discussionmentioning

confidence: 99%

Palliative care and healthcare utilization among deceased metastatic lung cancer patients in U.S. hospitals

et al. 2022

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Objective The benefits of palliative care for cancer patients were well developed; however, the characteristics of receiving palliative care and the utilization patterns among lung cancer patients have not been explored using a large-scale representative population-based sample. Methods The National Inpatient Sample of the United States was used to identify deceased metastatic lung cancer patients (n = 5,068, weighted n = 25,121) from 2010 to 2014. We examined the characteristics of receiving palliative care use and the association between palliative care and healthcare utilization, measured by discounted hospital charges and LOS (length of stay). The multivariate survey logistic regression model (to identify predictors for receipts of palliative care) and the survey linear regression model (to measure how palliative care is associated with healthcare utilization) were used. Results Among 25,121 patients, 50.1% had palliative care during the study period. Survey logistic results showed that patients with higher household income were more likely to receive palliative care than those in lower-income groups. In addition, during hospitalization, receiving palliative care was associated with11.2% lower LOS and 28.4% lower discounted total charges than the non-receiving group. Conclusion Clinical evidence demonstrates the benefits of palliative care as it is associated with efficient end-of-life healthcare utilization. Health policymakers must become aware of the characteristics of receiving the care and the importance of limited healthcare resource allocation as palliative care continues to grow in cancer treatment.

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Analysis of high-intensity care in intensive care units and its cost at the end of life among older people in South Korea between 2016 and 2019: a cross-sectional study of the health insurance review and assessment service national patient sample database

Lee

Kim

et al. 2021

BMJ Open

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ObjectivesTo provide useful information for clinicians and policy makers to prepare guidelines for adequate use of medical resources during end-of-life period by analysing the intensive care use and related costs at the end of life in South Korea.DesignCross-sectional, retrospective, observational study.SettingTertiary hospitals in South Korea.ParticipantsWe analysed claim data and patient information from the Health Insurance Review and Assessment Service national dataset. This dataset included 19 119 older adults aged 65 years or above who received high-intensity care at least once and died in the intensive care unit in South Korea between 2016 and 2019. High-intensity care was defined as one of the following treatments or procedures: cardiopulmonary resuscitation, mechanical ventilation, extra-corporeal membrane oxygenation, haemodialysis, transfusion, chemotherapy and vasopressors.Primary and secondary outcome measuresUsage and cost of high-intensity care.ResultsThe most commonly used high-intensity care was transfusion (68.9%), mechanical ventilation (50.6%) and haemodialysis (35.7%) during the study period. The annual cost of high-intensity care at the end of life increased steadily from 2016 to 2019. There existed differences by age, gender, length of hospital stays and primary cause of death in use of high-intensity care and associated costs.ConclusionFindings indicate that invasive and device-dependent high-intensity care is frequently provided at the end of life among older adults, which could potentially place an economic burden on patients and their families. In Korea’s ageing society, increased rates of chronic illness are expected to significantly burden those who lack the financial resources to provide end-of-life care. Therefore, guidelines for the use of high-intensity care are required to ensure affordable end-of-life care.

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Life-Sustaining Procedures, Palliative Care, and Cost Trends in Dying COPD Patients in U.S. Hospitals: 2005~2014

Cited by 3 publications

References 42 publications

Palliative care and healthcare utilization among metastatic breast cancer patients in U.S. Hospitals

Palliative care and healthcare utilization among metastatic breast cancer patients in U.S. Hospitals

Palliative care and healthcare utilization among deceased metastatic lung cancer patients in U.S. hospitals

Analysis of high-intensity care in intensive care units and its cost at the end of life among older people in South Korea between 2016 and 2019: a cross-sectional study of the health insurance review and assessment service national patient sample database

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