Survival, Mortality, and Location of Death for Patients Seen by a Hospital-Based Palliative Care Team

Abstract

We characterized patient outcomes following inpatient palliative care consultation: where patients are discharged, how long they live, and where they die. Two thirds of patients were able to be discharged, even when death occurred within two weeks. The low rates of readmission and death in an acute care hospital support that the decision to discharge the patients was reasonable and the discharge plan was adequate. Hospital based palliative care teams can play an important and unique role in discharge planning--allowing even patients very near death to leave the hospital if they wish.

Discharge Planning for Palliative Care Patients: A Qualitative Analysis

“…Approximately 33% of consults come from the general medicine or family practice wards, 21% from critical care and cardiology, and 13% from hematology/medical oncology and bone marrow transplantation. 9 The study was based on in-depth interviews with 19 patients and/or their caregivers. Palliative care team documentation in the medical chart was also reviewed to characterize the consultations.…”

“…Of patients discharged alive, only 10% were readmitted to OHSU within 30 days, 50% died within 12 days of discharge, and only 5% ultimately died in acute care hospitals. 7 In this study, many palliative care patients were exceedingly ill at the time of hospital discharge. The high rate of death outside the hospital raises important questions: were patients adequately prepared for discharge, and did they receive good care in their new settings?…”

End-of-Life Care for Hospitalized Patients with Lung Cancer: Utilization of a Palliative Care Service

“…17,18 Palliative care consultation facilitates earlier and more frequent hospice referral and lower hospital mortality. [19][20][21] Hospice care offers an alternative to life-prolonging inpatient care and is associated with better symptom control, improved patient and family satisfaction, and feelings of respect and inclusion in care decisions. 13,19 Hospice utilization by patients with lung cancer ranges from 25% to 30%, a rate typical of most cancer types, yet significantly greater than patients with non-cancer diagnoses.…”

“…[19][20][21] Hospice care offers an alternative to life-prolonging inpatient care and is associated with better symptom control, improved patient and family satisfaction, and feelings of respect and inclusion in care decisions. 13,19 Hospice utilization by patients with lung cancer ranges from 25% to 30%, a rate typical of most cancer types, yet significantly greater than patients with non-cancer diagnoses. 22 The purpose of the present study was to describe the characteristics of patients with lung cancer referred to a hospital-based palliative care service and compare them to patients receiving usual care.…”

Proceso de alta hospitalaria, revisión de la literatura

“…El uso de servicios de cuidados paliativos en el hospital en pacientes con patología terminal, ha demostrado disminuir el número de reingresos a 6 meses (p = 0,025) 88 y reducir el nivel de reingresos y de muertes de enfermos terminales en el hospital 89 . Gade también demostró que el uso de un equipo de cuidados paliativos disminuyó las admisiones a unidades de cuidados intensivos en los reingresos (p = 0,04), los costos (p = 0,001), y aumentó la estadía media en hospicios de pacientes con patología terminal (p = 0,04) 90 .…”