Trends, Predictors, and Potential Disparities of Palliative Care Utilization Among Older Adults With Hip Fractures: A Retrospective Analysis of the National Inpatient Sample, 2016-2020.

IF 1.3 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES Journal of Palliative Care Pub Date : 2024-10-15 DOI:10.1177/08258597241290982
Yuji Yamada, Takaaki Kobayashi, Patrick Ten Eyck, Renee Ren, Shigeki Fujitani, Fred Ko
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Abstract

Objectives: To assess the trends in palliative care consultation utilization and identify associated factors among older adults hospitalized with hip fractures in the United States between 2016 and 2020. Methods: We conducted a retrospective cohort study using data from the National Inpatient Sample from 2016 to 2020. The study included patients aged 65 and older admitted to hospital with a primary diagnosis of hip fracture. We identified palliative care consultations using ICD-10 code Z51.5. Multivariate logistic regression analyses were performed to identify predictors of palliative care utilization, adjusting for demographics, clinical variables, and hospital characteristics. Results: A total of 293,749 admissions for hip fractures were identified, of which 9546 (3.2%) had palliative care consultations. A consistent upward trend was seen in the proportion of patients receiving palliative care consultations across all fracture types. Patients of color (Black: odds ratio [OR] = 0.73, 95% confidence interval [CI]: 0.65-0.83; Hispanic: OR = 0.67, 95% CI: 0.60-0.75 compared to White), those in lower-income quartiles (lowest: OR = 0.81, 95% CI: 0.76-0.87 compared to highest), smaller hospital size (OR = 0.84, 95% CI: 0.79-0.89 compared to large), and rural hospital (OR = 0.63, 95% Cl: 0.59-0.68, compared to urban teaching) were associated with fewer palliative care consultations. Conclusion: The number of palliative care consultations during hip fracture hospital admission was low, although the proportion increased over time. Significant disparities were observed and further research should explore barriers to palliative care access and develop strategies to enhance its delivery across diverse healthcare settings.

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髋部骨折老年人使用姑息治疗的趋势、预测因素和潜在差异:2016-2020年全国住院患者样本回顾性分析》。
目的评估 2016 年至 2020 年间美国因髋部骨折住院的老年人使用姑息关怀咨询的趋势,并确定相关因素。方法我们利用 2016 年至 2020 年全国住院患者样本数据进行了一项回顾性队列研究。研究对象包括以髋部骨折为主要诊断入院的 65 岁及以上患者。我们使用 ICD-10 代码 Z51.5 确定了姑息治疗咨询。我们进行了多变量逻辑回归分析,以确定姑息治疗利用率的预测因素,并对人口统计学、临床变量和医院特征进行了调整。研究结果共确定了 293,749 例髋部骨折入院患者,其中 9546 例(3.2%)进行了姑息治疗咨询。在所有骨折类型中,接受姑息治疗的患者比例呈持续上升趋势。有色人种患者(黑人:几率比 [OR] = 0.73,95% 置信区间 [CI]:0.65-0.83;西班牙裔:与白人相比,OR = 0.67,95% CI:0.60-0.75)、收入较低的四分位数患者(收入最低:与收入最高相比,OR = 0.81,95% CI:0.76-0.87)、医院规模较小(与大型医院相比,OR = 0.84,95% CI:0.79-0.89)和农村医院(与城市教学医院相比,OR = 0.63,95% Cl:0.59-0.68)与姑息治疗咨询较少有关。结论髋部骨折患者入院期间接受姑息治疗咨询的人数较少,尽管这一比例随着时间的推移而增加。进一步的研究应探讨姑息关怀的使用障碍,并制定策略以加强在不同医疗环境中的姑息关怀服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Palliative Care
Journal of Palliative Care 医学-卫生保健
CiteScore
3.20
自引率
5.90%
发文量
63
审稿时长
>12 weeks
期刊介绍: The Journal of Palliative Care is a quarterly, peer-reviewed, international and interdisciplinary forum for practical, critical thought on palliative care and palliative medicine. JPC publishes high-quality original research, opinion papers/commentaries, narrative and humanities works, case reports/case series, and reports on international activities and comparative palliative care.
期刊最新文献
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