Outcomes of the Acute Palliative Care Unit in an Academic Medical Center

Eti, Serife; O’Mahony, Sean; McHugh, Marlene; Guilbe, Rose; Blank, Arthur E.; Selwyn, Peter A.

doi:10.1177/1049909113489164

Cited by 30 publications

(28 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another area of concern is that only a minority of NCI‐designated and non–NCI‐designated cancer centers reported having PCUs. Similar to the concept of intensive care units, PCUs are staffed by a highly specialized interdisciplinary team and are typically reserved for patients who require intensive symptom management . In a study of bereaved caregivers, patients who died in PCUs were perceived to have better quality of end‐of‐life care than patients who died outside PCUs .…”

Section: Discussionmentioning

confidence: 99%

State of palliative care services at US cancer centers: An updated national survey

Hui

Rosa

Chen

et al. 2020

Cancer

View full text Add to dashboard Cite

BACKGROUND: This study examined the changes in outpatient palliative care services at US cancer centers over the past decade. METHODS: Between April and August 2018, all National Cancer Institute (NCI)-designated cancer centers and a random sample of 1252 non-NCI-designated cancer centers were surveyed. Two surveys used previously in a 2009 national study were sent to each institution: a 22-question cancer center executive survey regarding palliative care infrastructure and attitudes toward palliative care and an 82question palliative care program leader survey regarding detailed palliative care structures and processes. Survey findings from 2018 were compared with 2009 data from 101 cancer center executives and 96 palliative care program leaders. RESULTS: The overall response rate was 69% (140 of 203) for the cancer center executive survey and 75% (123 of 164) for the palliative care program leader survey. Among NCI-designated cancer centers, a significant increase in outpatient palliative care clinics was observed between 2009 and 2018 (59% vs 95%; odds ratio, 12.3; 95% confidence interval, 3.2-48.2; P < .001) with no significant changes in inpatient consultation teams (92% vs 90%; P = .71), palliative care units (PCUs; 26% vs 40%; P = .17), or institution-operated hospices (31% vs 18%; P = .14). Among non-NCI-designated cancer centers, there was no significant increase in outpatient palliative care clinics (22% vs 40%; P = .07), inpatient consultation teams (56% vs 68%; P = .27), PCUs (20% vs 18%; P = .76), or institution-operated hospices (42% vs 23%; P = .05). The median interval from outpatient palliative care referral to death increased significantly, particularly for NCI-designated cancer centers (90 vs 180 days; P = 0.01). CONCLUSIONS: Despite significant growth in outpatient palliative care clinics, there remain opportunities for improvement in the structures and processes of palliative care programs.

show abstract

Section: Discussionmentioning

confidence: 99%

State of palliative care services at US cancer centers: An updated national survey

Hui

Rosa

Chen

et al. 2020

Cancer

View full text Add to dashboard Cite

show abstract

“…The service consists of a racially and ethnically diverse interdisciplinary team of clinicians with more than a decade of experience providing end-of-life care to patients in our urban, low-income, mainly minority population. 20,21 …”

Section: Methodsmentioning

confidence: 99%

Gaps in Provision of Primary and Specialty Palliative Care in the Acute Care Setting by Race and Ethnicity

Chuang

Hope

Allyn

et al. 2017

Journal of Pain and Symptom Management

View full text Add to dashboard Cite

Context Previous research has identified a large unmet need in provision of specialist-level palliative care services in the hospital. How much of this gap is filled by primary palliative care provided by generalists or non-palliative specialists has not been quantified. Estimates of racial and ethnic disparities have been inconsistent. Objectives 1) To estimate primary and specialty palliative care delivery and to measure unmet needs in the inpatient setting and 2) to explore racial and ethnic disparities in palliative care delivery. Methods This was a cross-sectional, retrospective study of 55,658 adult admissions to two acute care hospitals in the Bronx in 2013. Patients with palliative care needs were identified by criteria adapted from the literature. The primary outcomes were delivery of primary and specialist-level palliative care. Results 18.5% of admissions met criteria for needing palliative care. Of those, 18% received specialist-level palliative care, an estimated 30% received primary palliative care, and 37% had no evidence of palliative care or advance care planning. Black and Hispanic patients were not less likely to receive specialist-level palliative care (adjusted OR black patients=1.18, 95% CI 0.98, 1.42; adjusted OR Hispanic patients=1.24, 95% CI 1.04, 1.48), but they were less likely to receive primary palliative care (adjusted OR black patients= 0.41, 95% CI 0.20, 0.84; adjusted OR Hispanic patients=0.48, 95% CI 0.25, 0.94). Conclusions Even when considering primary and specialty palliative care, hospitalized patients have a high prevalence of unmet palliative care need. Further research is needed understand racial and ethnic disparities in palliative care delivery.

show abstract

“…For a few years, a new approach in managing patients with end-stage diseases in the hospital context is represented by the Acute Palliative Care Unit (APCU) [57]. The focus of the APCU is rapid symptom control and intensive psychosocial care, with a shorter length of stay and a lower death rate (20-50%) than those in hospice [58].…”

Section: How Do They Work Inhospital Palliative Care Services?mentioning

confidence: 99%

Inhospital Palliative Care: Should We Need to Reconsider What Role Hospitals Should Have in Patients with End-Stage Disease or Advanced Cancer?

Cotogni¹,

Saini²,

Luca³

2017

Preprint

View full text Add to dashboard Cite

show abstract

Outcomes of the Acute Palliative Care Unit in an Academic Medical Center

Abstract: Our data suggests that the APCU may provide cost effective, acute care for the patients with advanced chronic illness as well as the imminently dying in need of intensive symptom management.

Cited by 30 publications

References 14 publications

State of palliative care services at US cancer centers: An updated national survey

State of palliative care services at US cancer centers: An updated national survey

Gaps in Provision of Primary and Specialty Palliative Care in the Acute Care Setting by Race and Ethnicity

Inhospital Palliative Care: Should We Need to Reconsider What Role Hospitals Should Have in Patients with End-Stage Disease or Advanced Cancer?

Contact Info

Product

Resources

About