#SPSS VERSION 25 CITATION IN JAMA PC#
1 - 3 The prevalence of hospital-based PC services has increased by 26% during the past decade 67% of all hospitals and greater than 90% of hospitals with more than 300 beds currently offer PC services. The field of palliative care (PC) has expanded rapidly in response to patient and practitioner demand and increasing evidence of its value in caring for the sickest and most vulnerable patients in the US health care system. Variation in practice and outcomes among PCQN members suggests that there are opportunities for further improvements in care. Most patients with symptoms improved quickly. Compared with 2013, rates of discharge referral to clinic-based (OR, 4.00 95% CI, 2.95-5.43 P < .001) and home-based PC (OR, 2.63 95% CI, 1.92-3.61 P < .001) also increased significantly by 2017, whereas referrals to hospice decreased (OR, 0.56 95% CI, 0.51-0.62 P < .001).Ĭonclusions and Relevance Inpatient PC teams cared for an increasing percentage of patients with diagnoses other than cancer and saw more patients discharged alive, consistent with guidelines recommending specialty PC for all patients with serious illness earlier in their illnesses. Results A total of 135 197 patients were referred to inpatient PC (51.0% female mean age, 71.3 years ) and were significantly debilitated (mean Palliative Performance Scale score, 34.7% range, 14.9%-56.8%). Main Outcomes and Measures A total of 23 standardized data elements collected by PCQN teams that provided information about the characteristics of referred patients, including age, sex, Palliative Performance Scale score, and primary diagnosis leading to PC consult reason(s) given for the consultation and processes of care provided by the PC team, including disciplines involved, number of family meetings held, advance care planning documentation completed, and screened for and intervened on needs. Initial analyses of the study data were conducted from March 3 to March 21, 2018.
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A total of 135 197 patients were referred to PCQN teams during the study period. Objective To characterize current practice and trends among patients cared for and outcomes achieved by inpatient specialty PC services in the United States.ĭesign, Setting, and Participants This retrospective cohort study was performed from January 1, 2013, to December 31, 2017, at 88 US hospitals in which PC teams voluntarily participate in the Palliative Care Quality Network (PCQN), a national quality improvement collaborative. The field of PC has expanded and evolved rapidly, resulting in a need to characterize practice over time to understand whether it reflects evolving evidence and guidelines. Importance Although palliative care (PC) historically focused on patients with cancer and those near the end of life, evidence increasingly demonstrates a benefit to patients with a broad range of serious illnesses and to those earlier in their illness.
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Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.