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Original research
Association of palliative care and hospital outcomes among solid tumour oncology inpatients
  1. James HB Im1,
  2. Ronald Chow2,
  3. Madison Novosel1,
  4. Jenny Xiang1,
  5. Michael Strait1,
  6. Vinay Rao1,
  7. Jennifer Kapo1,
  8. Camilla Zimmermann2 and
  9. Elizabeth Prsic1
  1. 1 Yale School of Medicine, Yale University, New Haven, Connecticut, USA
  2. 2 Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Elizabeth Prsic, Yale University, New Haven, CT 06520, USA; elizabeth.prsic{at}yale.edu

Abstract

Objectives We aimed to explore the association between receiving an inpatient palliative care consultation and hospital outcomes, including in-hospital death, intensive care unit (ICU) use, discharge to hospice, 30-day readmissions and 30-day emergency department (ED) visits.

Methods We conducted a retrospective chart review of Yale New Haven Hospital medical oncology admissions from January 2018 through December 2021, with and without inpatient palliative care consultations. Hospital outcome data were extracted from medical records and operationalised as binary. Multivariable logistic regression was used to estimate ORs for the association between number of inpatient palliative care consultations and hospital outcomes.

Results Our sample included 19 422 patients. Age, Rothman Index, site of malignancy, length of stay, discharge to hospice, ICU admissions, hospital death and readmissions within 30 days differed significantly between patients who received versus did not receive a palliative care consultation. On multivariable analysis, receiving one additional palliative care consultation was significantly associated with higher odds of hospital death (adjusted OR=1.15, 95% CI 1.12 to 1.17) and discharge to hospice (adjusted OR = 1.23, 95% CI 1.20 to 1.26), and lower odds of ICU admission (adjusted OR=0.94, 95% CI 0.92 to 0.97). There was no significant association between palliative care consultations and readmission within 30 days or with ED visits within 30 days.

Conclusion Inpatients receiving palliative care had increased likelihood of hospital death. However, when controlling for significant differences in patient presentation, patients had nearly 25% greater odds of discharge to hospice and less odds to transition to ICU level of care.

Data availability statement

Data are available upon request.

https://doi.org/10.1136/spcare-2023-004207

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    Data availability statement

    Data are available upon request.

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    Footnotes

    • JHI and RC are joint first authors.

    • X @jennyxiangMD, @ElizabethPrsic

    • Contributors RC and EP were responsible for conception, planning and administration. JHBI, RC and EP were responsible for data analysis. All authors were responsible for manuscript writing and final approval. RC and EP are responsible for the overall content as the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.