Clinic-based outpatient palliative care before hospice is associated with longer hospice length of service

Carl Scheffey, Matthew G. Kestenbaum, Melissa W. Wachterman, Stephen R. Connor, Perry G. Fine, Malene S. Davis, J. Cameron Muir

Research output: Contribution to journalArticle

Abstract

Context. Outpatient nonhospice palliative care has been shown to provide many benefits to patients facing advanced illness, but such services remain uncommon in the U.S. Little is known about the association between clinicbased outpatient palliative care consultation and the timing of hospice enrollment.

Objectives. To determine whether there are differences in hospice length of service (LOS) between patients who were seen vs. patients who were not seen in an outpatient palliative care clinic before enrollment in hospice.

Methods. Using a retrospective study of medical records, a "prior palliative care clinic group was formed of those hospice patients who had had a nonhospice clinic-based outpatient palliative care consult before hospice admission (n = 354). For those patients, "control hospice patients without prior clinic-based palliative care were chosen who were matched by age, gender, median income of their zip code, and diagnostic group. Both groups were restricted to patients who died while enrolled in hospice. LOS for these two groups was compared using standard statistical methods of survival analysis.

Results. Prior palliative care clinic patients had a median LOS of 24 days, whereas control patients had a median LOS of 15 days (95% CI for difference between the medians 5e13 days). The difference between the LOS distribution curves was statistically significant by the log-rank test (P <0.001).

Conclusion. Hospice patients who had clinic-based outpatient palliative consults before hospice enrollment tended, on average, to have a longer LOS in hospice than patients who did not.

Original languageEnglish (US)
Pages (from-to)532-539
Number of pages8
JournalJournal of Pain and Symptom Management
Volume48
Issue number4
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Fingerprint

Hospices
Ambulatory Care
Palliative Care
Survival Analysis
Ambulatory Care Facilities
Medical Records
Outpatients
Referral and Consultation
Retrospective Studies

Keywords

  • clinic hospice
  • length of service
  • outpatient
  • Palliative
  • palliative care

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology
  • Nursing(all)
  • Medicine(all)

Cite this

Scheffey, C., Kestenbaum, M. G., Wachterman, M. W., Connor, S. R., Fine, P. G., Davis, M. S., & Muir, J. C. (2014). Clinic-based outpatient palliative care before hospice is associated with longer hospice length of service. Journal of Pain and Symptom Management, 48(4), 532-539. https://doi.org/10.1016/j.jpainsymman.2013.10.017

Clinic-based outpatient palliative care before hospice is associated with longer hospice length of service. / Scheffey, Carl; Kestenbaum, Matthew G.; Wachterman, Melissa W.; Connor, Stephen R.; Fine, Perry G.; Davis, Malene S.; Muir, J. Cameron.

In: Journal of Pain and Symptom Management, Vol. 48, No. 4, 01.10.2014, p. 532-539.

Research output: Contribution to journalArticle

Scheffey, C, Kestenbaum, MG, Wachterman, MW, Connor, SR, Fine, PG, Davis, MS & Muir, JC 2014, 'Clinic-based outpatient palliative care before hospice is associated with longer hospice length of service', Journal of Pain and Symptom Management, vol. 48, no. 4, pp. 532-539. https://doi.org/10.1016/j.jpainsymman.2013.10.017
Scheffey, Carl ; Kestenbaum, Matthew G. ; Wachterman, Melissa W. ; Connor, Stephen R. ; Fine, Perry G. ; Davis, Malene S. ; Muir, J. Cameron. / Clinic-based outpatient palliative care before hospice is associated with longer hospice length of service. In: Journal of Pain and Symptom Management. 2014 ; Vol. 48, No. 4. pp. 532-539.
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