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abstract
Highlights
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- Overall rate of hospice discharge and palliative care services is low but improving.
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- One fifth of the patients who died in the hospital received palliative care services.
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- One fifth of the patients with extreme risk of dying, but survived, were discharged to hospice.
Objective
To
investigate the trends in discharge to hospice, documented inpatient
palliative care services, and inpatient mortality in metastatic ovarian
cancer (mOvCa) patients.
Methods
Patients ≥ 18 years
with mOvCa and a non-elective admission between January 1, 2006 and
December 31, 2011 were identified from the National Inpatient Sample
(NIS). The primary outcome of interest was the temporal trend in the
annual proportion of hospitalizations for mOvCa where discharge
destination was hospice. Secondary outcomes included temporal trend of
inpatient mortality and documented palliative care services.
Multivariable logistic regression models were used to ascertain
independent factors predictive of hospice discharge and documented
palliative services across the clusters of hospitals.
Results
A
total of 106,203 non-elective hospitalizations were identified. The
rate of hospice discharge increased from 9.2% in 2004 to 11.1% in 2011. Similarly, the rate of documented palliative care services increased from 2.7% in 2004 to 10.4% in 2011. The inpatient mortality decreased from 9.6% in 2004 to 7.4% in 2011.
In a subset of hospitalizations with extreme risk of dying, 22% were
discharged to hospice and 11% received documented palliative care
services. One fifth of the patients who died in the hospital received
documented palliative care services.
Conclusions
The
use of hospice as a discharge destination and documented palliative
care services is relatively low but appears to be increasing over time
for mOvCa patients. Monitoring this data is vital to plan educational
programs regarding palliative care approaches in this at-risk
population.
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