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Am J Hosp Palliat Care · Dec 2012
Integrative palliative care, advance directives, and hospital outcomes of critically ill older adults.
- Ji Won Yoo, Shunichi Nakagawa, and Sulgi Kim.
- 1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA. yoojiw@trinity-health.org
- Am J Hosp Palliat Care. 2012 Dec 1; 29 (8): 655-62.
ObjectiveTo examine the associations between palliative care types and hospital outcomes for patients who have or do not have advance directives.MethodUsing administrative claims and clinical data for critically ill older adults (n = 1291), multivariable regressions examined the associations between palliative care types and hospital outcomes by advance directive status.ResultsIntegrative palliative care was associated with lower hospital costs, lower adjusted probability of in-hospital deaths, and higher adjusted probability of hospice discharges. There was no difference in hospital outcomes by palliative care types in those with advance directives.ConclusionSignificantly lower hospital costs and in-hospital deaths with higher hospice discharges were observed in integrative palliative care compared to consultative palliative care, but these findings were diminished with the presence of advance directives.
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