Use of Palliative Care in Patients With End-Stage COPD and Receiving Home Oxygen

Rush, Barret; Hertz, Paul; Bond, Alexandra; McDermid, Robert C.; Celi, Leo Anthony

doi:10.1016/j.chest.2016.06.023

Cited by 83 publications

(78 citation statements)

References 17 publications

(20 reference statements)

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“…Our study indicates that palliative care use among patients with metastatic NSCLC has grown significantly over the past decade, which is consistent with studies of palliative care for other chronic illnesses. For example, a similar increasing trend has been reported for patients with chronic obstructive pulmonary disease, from 0.45% in 2006 to 2.56% in 2012 . Similar trends have been observed within cancer care systems.…”

Section: Discussionsupporting

confidence: 73%

Utilization pattern and service settings of palliative care for patients with metastatic non–small cell lung cancer

Huo

Hong

Turner

et al. 2019

Cancer

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Background Although the benefits of palliative care for patients with cancer has been well established, the current utilization pattern remains largely unknown. The authors investigated the temporal trends and service settings of palliative care among Medicare beneficiaries with newly diagnosed, metastatic non–small cell lung cancer (NSCLC). Methods In total, 69,414 patients with NSCLC were identified between January 1, 2001 and December 31, 2013 from the Surveillance, Epidemiology, and End Results‐Medicare–linked database. Temporal trends in palliative care use and the temporal shift in palliative care service settings were assessed using the Cochran‐Armitage test. Multivariable logistic regression models were used to identify predictors for the receipt of palliative care, controlling for patients' sociodemographic and clinical characteristics. Results Fifteen percent (10,359) of patients with NSCLC received palliative care within 1 year of a diagnosis of metastatic NSCLC. The proportion of beneficiaries receiving palliative care increased from 3.6% in 2001 to 31.9% in 2013 (P for trend <.001). Multivariable analyses demonstrated that receipt of palliative care varied significantly by sex, race, and region. Most patients (53.5%) had their first receipt of palliative care in a hospital. Less than one‐third of patients (27.6%) received palliative care in an outpatient setting or received palliative care in more than 1 service setting (26.3%) in 2013. Conclusions The number of patients with metastatic NSCLC receiving palliative care has increased substantially. Although the hospital‐based program is still the main form of palliative care delivery, more patients in recent years have received palliative care services in multiple locations.

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Section: Discussionsupporting

confidence: 73%

Utilization pattern and service settings of palliative care for patients with metastatic non–small cell lung cancer

Huo

Hong

Turner

et al. 2019

Cancer

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“…First, the role and awareness of PC in the management of patients with significant symptom burdens have increased over the past few years. While there has been a traditionally accepted role for PC in oncology patients, the benefits of PC in noncancer patients have been increasingly recognized . Moreover, increased referral to PC in larger teaching hospitals likely reflects the increased availability of specialized PC services and units in these hospitals as formal PC units and consultation teams have become commonplace in hospitals across the United States …”

Section: Discussionmentioning

confidence: 99%

Palliative care access for hospitalized patients with end‐stage liver disease across the United States

et al. 2017

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“…13 As an example, the higher rates of DNR status in the highest income quartile likely reflect increased access to primary care as well as palliative care. 6,29 …”

Section: Discussionmentioning

confidence: 99%

Association of Household Income Level and In-Hospital Mortality in Patients With Sepsis: A Nationwide Retrospective Cohort Analysis

Rush

Wiskar

Celi

et al. 2017

J Intensive Care Med

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Objective Associations between low socioeconomic status (SES) and poor health outcomes have been demonstrated in a variety of conditions. However, the relationship in patients with sepsis is not well described. We investigated the association of lower household income with in-hospital mortality in patients with sepsis across the United States. Methods Retrospective nationwide cohort analysis utilizing the Nationwide Inpatient Sample (NIS) from 2011. Patients aged 18 years or older with sepsis were included. Socioeconomic status was approximated by the median household income of the zip code in which the patient resided. Multivariate logistic modeling incorporating a validated illness severity score for sepsis in administrative data was performed. Results A total of 8 023 590 admissions from the 2011 NIS were examined. A total of 671 858 patients with sepsis were included in the analysis. The lowest income residents compared to the highest were younger (66.9 years, standard deviation [SD] = 16.5 vs 71.4 years, SD = 16.1, P < .01), more likely to be female (53.5% vs 51.9%, P < .01), less likely to be white (54.6% vs 76.6%, P < .01), as well as less likely to have health insurance coverage (92.8% vs 95.9%, P < .01). After controlling for severity of sepsis, residing in the lowest income quartile compared to the highest quartile was associated with a higher risk of mortality (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.03–1.08, P < .01). There was no association seen between the second (OR: 1.02, 95% CI: 0.99–1.05, P = .14) and third (OR: 0.99, 95% CI: 0.97–1.01, P = .40) quartiles compared to the highest. Conclusion After adjustment for severity of illness, patients with sepsis who live in the lowest median income quartile had a higher risk of mortality compared to residents of the highest income quartile. The association between SES and mortality in sepsis warrants further investigation with more comprehensive measures of SES.

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Use of Palliative Care in Patients With End-Stage COPD and Receiving Home Oxygen

Abstract: The use of PC increased dramatically during the study period; however, PC contact occurs only in a minority of patients with end-stage COPD admitted with an exacerbation.

Cited by 83 publications

References 17 publications

Utilization pattern and service settings of palliative care for patients with metastatic non–small cell lung cancer

Utilization pattern and service settings of palliative care for patients with metastatic non–small cell lung cancer

Palliative care access for hospitalized patients with end‐stage liver disease across the United States

Association of Household Income Level and In-Hospital Mortality in Patients With Sepsis: A Nationwide Retrospective Cohort Analysis

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