Journal of palliative medicine
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Prior research indicates that hospice and palliative care delivered in outpatient settings are associated with reduced hospital readmissions for cancer patients. However, little is known about how inpatient palliative care affects readmissions in oncology. ⋯ The effect of inpatient palliative care on readmissions in oncology is largely driven by hospice enrollment. Strategies that combine palliative care consultation with hospice discharge may decrease hospital readmissions and improve cancer care quality.
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Black patients are more likely than white patients to die in the hospital with intensive care and life-sustaining treatments and less likely to use hospice. Regional concentration of high end-of-life (EOL) treatment intensity practice patterns may disproportionately affect black patients. We calculated and compared race-specific hospital-level EOL treatment intensity in Pennsylvania. ⋯ In Pennsylvania, black-serving hospitals have higher standardized EOL treatment intensity than nonblack-serving hospitals, contributing to black patients' relatively higher use of intensive treatment. However, conditional on being admitted to the same high-intensity hospital and after risk adjustment, blacks are less intensively treated than whites.
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Our aim was to obtain initial estimates of the effect of a palliative care and medical oncology co-rounding model on hospital length of stay, proportion of patients reviewed by specialist palliative care (SPC), and proportion of patients who were readmitted within 7 and 30 days of hospital discharge. ⋯ In our target population, the co-rounding model was associated with a shorter hospital length of stay.
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To describe prevalence and content of AD documentation among NH residents by dementia stage. ⋯ While dementia severity was associated with greater likelihood of having documented any AD, almost 4 in 10 residents with dementia lacked any AD. Effective outreach may focus efforts on subgroups with lower odds of any AD or living wills, including non-white, less educated, and unmarried NH residents. A greater understanding of how such factors impact care planning will help to address barriers to patient-centered care for this population.
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The My Kite Will Fly (MKWF) research program is built on the well-documented need for effective clinical communication tools and therapeutic interventions where a child's mother is diagnosed with life-threatening gynecological cancer. ⋯ Results from this pilot cohort confirm the importance of enhanced parent-child communication and stabilized family routines. Current results provide an important platform for future evaluative research among larger patient-family populations across multisite oncology settings.