Associations Between Timing of Palliative Care Consults and Family Evaluation of Care Among Veterans
Year: 2017
Type: conference-abstract
Abstract: Palliative care consultations (PCC) improve end-of-life (EOL) care but often occur late in an illness trajectory. There is limited evidence about the optimal timing of PCC to enhance patient outcomes. The purpose of this analysis was to examine the associations between PCC timing and bereaved families’ evaluation of care in the last 30 days of life. The retrospective, observational analysis included 5,592 patients whose first PCC occurred before admission to and death in a Veterans Administration (VA) inpatient hospice unit. Data were collected between October 2011 and September 2014. Outcomes included an overall rating of care and three factor scores (Respectful Care and Communication, Emotional/Spiritual Support, Information about Death Benefits) from the Bereaved Family Survey (BFS), a national, validated quality improvement measure used in the VA. We used multi-variate logistic regression models clustered by facility and controlled for potential confounding variables found to be associated with the outcomes. Family members of Veterans whose first PCC occurred 31–180 days prior to death were more likely to rate overall care as excellent compared with those whose PCC occurred 0–3 days prior to death (AOR=1.56; 95%CI, 1.25–1.95). Respectful Care and Communication and Emotional/Spiritual Support also were significantly higher when the first PCC occurred 31–180 days prior to the Veteran’s death (β = 0.53; 95%CI, 0.29–0.76 and β = 0.31; 95%CI, 0.04–0.57, respectively). Earlier PCC is associated with greater family satisfaction with EOL care. Strategies aimed at conducting PCC earlier in life limiting illness are needed.
Source: Innovation in Aging
Authors: M. McDarby, J. Carpenter, M.T. Ersek, J. Thorpe, D. Smith, M. Johnson
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,977
OpenAlex ID: W2729667164