• Jean C Digitale, Sarah S Nouri, Eve L Cohen, Brook A Calton, Michael W Rabow, Steven Z Pantilat, and Kara E Bischoff.
• Department of Epidemiology and Biostatistics (J.C.D.), University of California San Francisco , San Francisco, California, USA.
• J Pain Symptom Manage. 2023 Aug 1; 66 (2): e163e176e163-e176.

ContextLittle is known about equity in utilization of outpatient palliative care (PC).ObjectivesTo explore whether patient-level factors are associated with completing initial and follow-up visits among patients referred to outpatient PC.MethodsUsing electronic health record data, we generated a cohort of all adults referred to outpatient PC at University of California, San Francisco October 2017-October 2021. We assessed whether demographic and clinical characteristics were associated with completion of 1) an initial PC visit and 2) at least one follow-up visit.ResultsOf patients referred to outpatient PC (N = 6,871), 60% completed an initial visit; 66% of those who established care returned for follow-up. In multivariable models, patients who were less likely to complete an initial visit were older (OR per decade 0.94; 95% confidence interval [CI] 0.89-0.98), Black (OR 0.71; 95% CI 0.56-0.90), Latinx (OR 0.69; 95% CI 0.57-0.83), unpartnered (OR 0.80; 95% CI 0.71-0.90), and had Medicaid (OR 0.82; 95% CI 0.69-0.97). Among patients who completed an initial visit, those less likely to complete a follow-up visit were older (OR 0.88; 95% CI 0.82-0.94), male (OR 0.83; 95% CI 0.71-0.96), preferred a language other than English (0.71; 95% CI 0.54-0.95), and had a serious illness other than cancer (OR 0.74; 95% CI 0.61-0.90).ConclusionWe found that Black and Latinx patients were less likely to complete an initial visit and those with a preferred language other than English were less likely to complete a follow-up visit. To promote equity in PC, these differences and their impact on outcomes must be explored.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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