• Donald R Sullivan, Katie F Jones, Melissa W Wachterman, Hilary L Griffin, Daniel Kinder, Dawn Smith, Joshua Thorpe, Shelli L Feder, Mary Ersek, and Ann Kutney-Lee.
• Department of Medicine (D.R.S.), Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, Portland Oregon, USA; Center to Improve Veteran Involvement in Care (D.R.S.), Portland Veteran Affairs Healthcare System, Portland Oregon, USA. Electronic address: sullivad@ohsu.edu.
• J Pain Symptom Manage. 2024 Oct 1; 68 (4): 329339329-339.

ContextLittle is known about Veterans who die during a short terminal admission, which renders them ineligible for the Department of Veterans Affairs (VA) Bereaved Family Survey.ObjectivesWe sought to describe this population and identify opportunities to improve end-of-life (EOL) care quality.MethodsRetrospective, cohort analysis of Veteran decedents who died in a VA inpatient setting between October 2018-September 2019. Veterans were dichotomized by short (<24 hours) and long (≥24 hours) terminal admissions; sociodemographics, clinical characteristics, VA and non-VA healthcare use, and EOL care quality indicators were compared.ResultsAmong 17,033 inpatient decedents, 723 (4%) had short terminal admissions. Patients with short compared to long terminal admissions were less likely to have a VA hospitalization (38% vs. 54%) in the last 90 days of life and were more likely to die in an intensive care (49% vs 21%) or acute care (27% vs 18%) unit. Patients with a short compared to long admission were about half as likely to receive hospice (33% vs 64%) or palliative care (33% vs 69%). Most patients with short admissions (76%) had a life-limiting condition (e.g., cancer, chronic obstructive pulmonary disease) and those with cancer were more likely to receive palliative care compared to those with non-cancer conditions.ConclusionVeterans with short terminal admissions are less likely to receive hospice or palliative care compared to patients with long terminal admissions. Many patients with short terminal admissions, such as those with life-limiting conditions (especially cancer), receive aspects of high-quality EOL care, however, opportunities for improvement exist.Copyright © 2024 American Academy of Hospice and Palliative Medicine. All rights reserved.

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