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Advance care planning and hospital outcomes in solid tumour oncology inpatients
  1. Denis Qeska1,
  2. Ronald Chow1,
  3. Tracy A Balboni2,
  4. Jennifer Kapo3,
  5. Camilla Zimmermann1 and
  6. Elizabeth Prsic3
  1. 1 Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  2. 2 Harvard Medical School, Harvard University, Boston, Massachusetts, USA
  3. 3 Yale School of Medicine, Yale University, New Haven, Connecticut, USA
  1. Correspondence to Dr Elizabeth Prsic, Yale University, New Haven, CT 06520, USA; elizabeth.prsic{at}yale.edu

Abstract

Objectives To assess the association between advance care planning (ACP) and outcomes of in-hospital mortality, 30-day hospital readmission and 30-day emergency department (ED) visits among patients with cancer.

Methods This observational cohort analysis included patients with solid tumour malignancies receiving oncology care and admitted at Yale New Haven Hospital between 1 January 2018 and 31 December 2021.

Results Among 19 422 patients, 1283 (6.6%) had a documented ACP note. Compared with patients without an ACP, patients with an ACP tended to be older, have longer LOS, be admitted to an oncology inpatient team, subsequently admitted to intensive care unit and have a lower Rothman Index. Multivariable logistic regression identified ACP as independently associated with decreased 30-day readmission (OR=0.70 (95% CI: 0.60 to 0.82)) and 30-day ED visit (OR=0.79 (95% CI: 0.68 to 0.91)), adjusting for in-hospital mortality and patient characteristics.

Conclusion ACP documentation is associated with decreased readmissions and ED visits, independent of hospice utilisation.

https://doi.org/10.1136/spcare-2023-004396

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    Footnotes

    • DQ and RC are joint first authors.

    • X @ElizabethPrsic

    • Contributors Conceptualisation: RC and EP. Methodology: RC. Software: RC. Validation: RC. Formal analysis: RC. Investigation: DQ, RC and EP. Resources: RC and EP. Data curation: RC and EP. Writing—original draft: DQ, RC and EP. Writing—review and editing and all supervision. TAB, CZ and EP. Project administration: RC and EP.

    • 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; externally peer reviewed.