Association of Inpatient Palliative Care with Health Care Utilization and Postdischarge Outcomes among Medicare Beneficiaries with End Stage Kidney Disease

Clinical Journal of the American Society of Nephrology : CJASN
Alexis ChettiarManjula Kurella Tamura

Abstract

Palliative care may improve quality of life and reduce the cost of care for patients with chronic illness, but utilization and cost implications of palliative care in ESKD have not been evaluated. We sought to determine the association of inpatient palliative care with health care utilization and postdischarge outcomes in ESKD. In analyses stratified by whether patients died during the index hospitalization, we identified Medicare beneficiaries with ESKD who received inpatient palliative care, ascertained by provider specialty codes, between 2012 and 2013. These patients were matched to hospitalized patients who received usual care using propensity scores. Primary outcomes were length of stay and hospitalization costs. Secondary outcomes were 30-day readmission and hospice enrollment. Inpatient palliative care occurred in <1% of hospitalizations lasting >2 days. Among the decedent cohort (n=1308), inpatient palliative care was associated with a 21% shorter length of stay (-4.2 days; 95% confidence interval, -5.6 to -2.9 days) and 14% lower hospitalization costs (-$10,698; 95% confidence interval, -$17,553 to -$3843) compared with usual care. Among the nondecedent cohort (n=5024), inpatient palliative care was associated with no...Continue Reading

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Citations

Jul 22, 2018·Clinical Journal of the American Society of Nephrology : CJASN·Vanessa Grubbs
Jan 4, 2020·Seminars in Dialysis·Deidra C Crews, Tessa K Novick
Aug 25, 2020·JAMA Network Open·Gwen M BernackiAnn M O'Hare
Jul 15, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Simit Doshi, Jay B Wish
Aug 8, 2019·Journal of the American Society of Nephrology : JASN·Yumeng WenLili Chan
Feb 11, 2021·Clinical Kidney Journal·Manon J M van OostenVianda S Stel
Jan 19, 2022·Circulation. Cardiovascular Quality and Outcomes·Leila HaghighatNihar R Desai
Nov 7, 2018·Journal of Pain and Symptom Management·Kabir O OlaniranNwamaka D Eneanya

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