Factors associated with utilization of an inpatient palliative care consultation service in an urban public hospital

Am J Hosp Palliat Care. 2014 Sep;31(6):641-4. doi: 10.1177/1049909113502845. Epub 2013 Aug 28.

Abstract

Rationale: To evaluate factors associated with palliative care consultation (PCC) in an urban public hospital.

Methods: A retrospective chart review of patients who died on inpatient medical services.

Results: Patients with a PCC were more likely to have a "do not resuscitate" (DNR) order at the time of death (p<0.001) and had a decreased likelihood of death in the ICU (p<0.001). Factors associated with PCC in a multivariate analysis included: cancer diagnosis (p=0.01), at least a high school education (p=0.04), older age (p=.003), and birth outside the US (p=0.03).

Conclusion: The increased PCC utilization for immigrants is in contrast to previously reported literature. This increased use may be because access to services in a municipal hospital is not driven by demographic and socioeconomic factors.

Keywords: disparities; end of life; goals of care; inpatient; palliative; urban; utilization.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Emigrants and Immigrants / statistics & numerical data
  • Female
  • Hospitals, Public / statistics & numerical data*
  • Hospitals, Urban / statistics & numerical data*
  • Humans
  • Inpatients*
  • Male
  • Middle Aged
  • New York City
  • Palliative Care / statistics & numerical data*
  • Resuscitation Orders
  • Retrospective Studies
  • Socioeconomic Factors