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Am J Hosp Palliat Care · Jun 2013
The effects of the Palliative Medicine Consultation on the DNR status of African Americans in a safety-net hospital.
- Joseph Sacco, Dana R Deravin Carr, and Deborah Viola.
- Palliative Medicine Consultation Service/Hospice Inpatient Unit, Bronx Lebanon Hospital Center, Bronx, NY, USA.
- Am J Hosp Palliat Care. 2013 Jun 1;30(4):363-9.
ObjectiveTo examine the effectiveness of palliative medicine consultation on completion of advance directives/do-not-resuscitate (DNR) orders by racial/ethnic minorities.MethodA sample of 1999 seriously ill African American and Hispanic inpatients was obtained from the Palliative Medicine Consultation database (n = 2972). Associations between race/ethnicity and diagnosis and documentation of DNR status on admission and discharge were examined.ResultsCancer was the primary diagnosis, 34.5%. Among patients with a consultation, 98% agreed to discuss advance directives; 65% of African Americans and 70% of Hispanics elected DNR status. Inpatient deaths were 46%; 74% of decedents agreed to DNR orders. Discharged patients referred to hospice were 29%.ConclusionPalliative medicine consultations resulted in timely completion of DNR orders and were positively associated with DNR election and hospice enrollment.
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