دورية أكاديمية
Suboptimal Use of Inpatient Palliative Care Consultation May Lead to Higher Readmissions and Costs in End-Stage Liver Disease.
| العنوان: | Suboptimal Use of Inpatient Palliative Care Consultation May Lead to Higher Readmissions and Costs in End-Stage Liver Disease. |
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| المؤلفون: | Adejumo AC; Department of Medicine, North Shore Medical Center, Salem, Massachusetts.; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts., Kim D; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California., Iqbal U; Department of Medicine, Geisinger Medical Center, Danville, Pennsylvania., Yoo ER; Department of Internal Medicine, Santa Clara Valley Medical Center, San Jose, California., Boursiquot BC; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California., Cholankeril G; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California., Wong RJ; Division of Gastroenterology and Hepatology, Alameda Health System-Highland Hospital, Oakland, California., Kwo PY; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California., Ahmed A; Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California. |
| المصدر: | Journal of palliative medicine [J Palliat Med] 2020 Jan; Vol. 23 (1), pp. 97-106. Date of Electronic Publication: 2019 Aug 09. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 9808462 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-7740 (Electronic) Linking ISSN: 15577740 NLM ISO Abbreviation: J Palliat Med Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., c1998- |
| مواضيع طبية MeSH: | End Stage Liver Disease* , Patient Readmission*, Hospitalization ; Humans ; Inpatients ; Length of Stay ; Palliative Care ; Referral and Consultation ; Retrospective Studies ; United States |
| مستخلص: | Background/Aims: Patients with end-stage liver disease (ESLD) have a high risk for readmission. We studied the role of palliative care consultation (PCC) in ESLD-related readmissions with a focus on health care resource utilization in the United States. Methods: We performed a retrospective longitudinal analysis on patients surviving hospitalizations with ESLD from January 2010 to September 2014 utilizing the Nationwide Readmissions Database with a 90-day follow-up after discharge. We analyzed annual trends in PCC among patients with ESLD. We matched PCC to no-PCC (1:1) using propensity scores to create a pseudorandomized clinical study. We estimated the impact of PCC on readmission rates (30- and 90-day), and length of stay (LOS) and cost during subsequent readmissions. Results: Of the 67,480 hospitalizations with ESLD, 3485 (5.3%) received PCC, with an annual increase from 3.6% to 6.7% ( p for trend <0.01). The average 30- and 90-day annual readmission rates were 36.2% and 54.6%, respectively. PCC resulted in a lower risk for 30- and 90-day readmissions (hazard ratio: 0.42, 95% confidence interval [CI]: 0.38-0.47 and 0.38, 95% CI: 0.34-0.42, respectively). On subsequent 30- and 90-day readmissions, PCC was associated with decreased LOS (5.6- vs. 7.4 days and 5.7- vs. 6.9 days, p < 0.01) and cost (US $48,752 vs. US $75,810 and US $48,582 vs. US $69,035, p < 0.01). Conclusion: Inpatient utilization of PCC for ESLD is increasing annually, yet still remains low in the United States. More importantly, PCC was associated with a decline in readmission rates resulting in a lower burden on health care resource utilization and improvement in cost savings during subsequent readmissions. |
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| معلومات مُعتمدة: | T32 DK007056 United States DK NIDDK NIH HHS |
| فهرسة مساهمة: | Keywords: Nationwide Readmissions Database; cirrhosis; cost; length of stay |
| تواريخ الأحداث: | Date Created: 20190810 Date Completed: 20210618 Latest Revision: 20210618 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC6931914 |
| DOI: | 10.1089/jpm.2019.0100 |
| PMID: | 31397615 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1557-7740 |
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| DOI: | 10.1089/jpm.2019.0100 |