Association of Palliative Care With Readmission and Resource Utilization in Patients With Ovarian Cancer: A National Perspective.

Alex A Francoeur, Nikhil Chervu, Alexandra L Mardock, Samantha Solaru, Sara Sakowitz, Peyman Benharash, Tiffany S Lai
{"title":"Association of Palliative Care With Readmission and Resource Utilization in Patients With Ovarian Cancer: A National Perspective.","authors":"Alex A Francoeur, Nikhil Chervu, Alexandra L Mardock, Samantha Solaru, Sara Sakowitz, Peyman Benharash, Tiffany S Lai","doi":"10.1177/10499091241301753","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Palliative care (PC) utilization in cancer care has been shown to alleviate symptoms, increase goals of care discussions, and reduce invasive end of life measures. This study examined the association of inpatient PC consultation with readmission and hospitalization costs among patients with ovarian cancer.</p><p><strong>Methods: </strong>All records for women (≥18 years) hospitalized with a diagnosis of ovarian cancer were tabulated from the 2010-2020 Nationwide Readmissions Database. Multivariable logistic, Poisson, and linear regressions were used to evaluate the association of PC consultation during index hospitalization with length of stay, rates of 30-day non-elective readmission, time to readmission, as well as overall number of readmissions and hospitalization costs.</p><p><strong>Results: </strong>Of an estimated 285,487 patients included, 25,957 (9.0%) received a PC consultation, with an increase from 5.1 to 11.7% (<i>P</i> < 0.001) across the period. Factors associated with use of PC included: increasing age (AOR 1.03/yr, 95% CI 1.03-1.03, <i>P</i> < 0.001) and Elixhauser comorbidity index (AOR 1.19/point, 95% CI 1.17-1.21). PC was associated with lower risk adjusted rates of 30 day (11.63%, 95% CI 11.0-12.3 vs 20.25%, 95% CI 20.0-20.6) non-elective readmission (<i>P</i> < 0.001). The adjusted incident rate ratio of readmission after PC consultation was 0.41 [0.38-0.43], <i>P</i> < 0.001. Patients receiving PC additionally had less cost associated with their index hospital stay; -$2,407 [-$2,669.86- -$2,144.43], <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Inpatient PC consults appear to be associated with reduced medical readmissions for patients with ovarian cancer, as well as decreased hospital resource use, however disparities exist. Continued increase in access and early PC referral should be considered.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091241301753"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The American journal of hospice & palliative care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/10499091241301753","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Palliative care (PC) utilization in cancer care has been shown to alleviate symptoms, increase goals of care discussions, and reduce invasive end of life measures. This study examined the association of inpatient PC consultation with readmission and hospitalization costs among patients with ovarian cancer.

Methods: All records for women (≥18 years) hospitalized with a diagnosis of ovarian cancer were tabulated from the 2010-2020 Nationwide Readmissions Database. Multivariable logistic, Poisson, and linear regressions were used to evaluate the association of PC consultation during index hospitalization with length of stay, rates of 30-day non-elective readmission, time to readmission, as well as overall number of readmissions and hospitalization costs.

Results: Of an estimated 285,487 patients included, 25,957 (9.0%) received a PC consultation, with an increase from 5.1 to 11.7% (P < 0.001) across the period. Factors associated with use of PC included: increasing age (AOR 1.03/yr, 95% CI 1.03-1.03, P < 0.001) and Elixhauser comorbidity index (AOR 1.19/point, 95% CI 1.17-1.21). PC was associated with lower risk adjusted rates of 30 day (11.63%, 95% CI 11.0-12.3 vs 20.25%, 95% CI 20.0-20.6) non-elective readmission (P < 0.001). The adjusted incident rate ratio of readmission after PC consultation was 0.41 [0.38-0.43], P < 0.001. Patients receiving PC additionally had less cost associated with their index hospital stay; -$2,407 [-$2,669.86- -$2,144.43], P < 0.001).

Conclusions: Inpatient PC consults appear to be associated with reduced medical readmissions for patients with ovarian cancer, as well as decreased hospital resource use, however disparities exist. Continued increase in access and early PC referral should be considered.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
姑息治疗与卵巢癌患者再入院和资源利用的关系:全国视角。
目的:在癌症治疗中使用姑息治疗(PC)已被证明可减轻症状、增加治疗目标讨论并减少生命末期的侵入性措施。本研究调查了卵巢癌患者住院姑息治疗咨询与再入院和住院费用之间的关系:从 2010-2020 年全国再入院数据库中统计了所有诊断为卵巢癌的女性(≥18 岁)住院记录。采用多变量逻辑回归、泊松回归和线性回归评估住院期间PC咨询与住院时间、30天非选择性再入院率、再入院时间以及再入院总数和住院费用的关系:在纳入的约 285,487 名患者中,25,957 人(9.0%)接受了 PC 会诊,会诊率从 5.1% 增加到 11.7%(P < 0.001)。使用 PC 的相关因素包括:年龄增加(AOR 1.03/年,95% CI 1.03-1.03,P <0.001)和 Elixhauser 合并症指数(AOR 1.19/点,95% CI 1.17-1.21)。PC 与较低的 30 天非选择性再入院风险调整率(11.63%,95% CI 11.0-12.3 vs 20.25%,95% CI 20.0-20.6)相关(P < 0.001)。接受个人护理咨询后,调整后的再入院事件发生率比为 0.41 [0.38-0.43],P < 0.001。此外,接受个人护理的患者在住院期间的相关费用为-2,407美元 [-2,669.86--2,144.43美元],P < 0.001):住院PC咨询似乎与卵巢癌患者再住院率的降低以及医院资源使用的减少有关,但也存在差异。应考虑继续增加 PC 的使用机会并尽早转诊。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
End of Life Outcomes Following Comfort Care Orders: A Single Center Experience. Trends, Sociodemographic and Hospital-Level Factors Associated with Palliative Care Utilization Among Metastatic Prostate Cancer Patients. Beyond the Diagnosis: A Deep Dive Into the End Stage Liver Disease Experience From the Patient Perspective. End-Of-Life Symptoms and Symptom Management in Older Adults With Stroke Versus Cancer. Truth on ProQOL and Burnout Assessment-Development and Intercultural Validation of the Brief ProQOL-12 from the Professional Quality of Life, Version 5.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1