ArticleAnnals of the American Thoracic Society2018
Association between the Availability of Hospital-based Palliative Care and Treatment Intensity for Critically Ill Patients.
Article in Annals of the American Thoracic Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed.
- Effect of Documenting Prognosis on the Information Provided to ICU Proxies: A Randomized Trial.Critical care medicine · 2019Trial
- Trends in discharge to hospice after critical illness among US Medicare beneficiaries, 2011-2023.Annals of the American Thoracic Society · 2026Article
- Palliative Care Utilization Among Hospitalized Patients With Common Chronic Conditions in the United States.Journal of palliative care · 2026Article
- Variation in Palliative Care Program Performance for Patients With Metastatic Cancer.Journal of pain and symptom management · 2025Article
- Clinical outcomes of a joint ICU and palliative care multidisciplinary rounding model: A retrospective cohort study.PloS one · 2024Article
- Decline in Prolonged Acute Mechanical Ventilation, 2011-2019.American journal of respiratory and critical care medicine · 2022Article
- What Affects Adoption of Specialty Palliative Care in Intensive Care Units: A Qualitative Study.Journal of pain and symptom management · 2021Article
- Implementation of Specialist Palliative Care and Outcomes for Hospitalized Patients with Dementia.Journal of the American Geriatrics Society · 2021Article
- A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admissions and bed days in people nearing the end of their life: much innovation, but limited supporting evidence.BMC palliative care · 2020Article
- Association Between the Implementation of Hospital-Based Palliative Care and Use of Intensive Care During Terminal Hospitalizations.JAMA network open · 2020Article
- Determining the Association Between End-of-Life Care Resources and Patient Outcomes in Pennsylvania ICUs.Critical care medicine · 2019Article
- Update in Critical Care and Acute Respiratory Distress Syndrome 2018.American journal of respiratory and critical care medicine · 2019Article
- Comparison of Care Patterns and Rehospitalizations for Mechanically Ventilated Patients in New York and Ontario.Annals of the American Thoracic Society · 2019Article
- Defining the Value Proposition for Specialist Palliative Care Delivered in Intensive Care Units.Annals of the American Thoracic Society · 2018Article
- Association between the Availability of Hospital-based Palliative Care and Treatment Intensity for Critically Ill Patients.Annals of the American Thoracic Society · 2018Article
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5 authors.
Funding
Abstract
rationaleIn the intensive care unit (ICU), studies involving specialized palliative care services have shown decreases in the use of nonbeneficial life-sustaining therapies and ICU length of stay for patients. However, whether widespread availability of hospital-based palliative care is associated with less frequent use of high intensity care is unknown.
objectivesTo determine whether availability of hospital-based palliative care is associated with decreased markers of treatment intensity for ICU patients.
methodsRetrospective cohort study of adult ICU patients in New York State hospitals, 2008-2014. Multilevel regression was used to assess the relationship between availability of hospital-based palliative care during the year of admission and hospital length of stay, use of mechanical ventilation, dialysis and artificial nutrition, placement of a tracheostomy or gastrostomy tube, days in ICU and discharge to hospice.
resultsOf 1,025,503 ICU patients in 151 hospitals, 814,794 (79.5%) received care in a hospital with a palliative care program. Hospital length of stay was similar for patients in hospitals with and without palliative care programs (6 d [interquartile range, 3-12] vs. 6 d [interquartile range, 3-11]; adjusted rate ratio, 1.04 [95% confidence interval 1.03-1.05]; P < 0.001), as were other healthcare use outcomes. However, patients in hospitals with palliative care programs were 46% more likely to be discharged to hospice than those in hospitals without palliative care programs (1.7% vs. 1.4%; adjusted odds ratio, 1.46 [95% confidence interval 1.30-1.64]; P < 0.001).
conclusionsThe availability of hospital-based palliative care was not associated with differences in in-hospital treatment intensity, but it was associated with significantly increased hospice use for ICU patients. Currently, the measurable benefit of palliative care programs for critically ill patients may be the increased use of hospice facilities, as opposed to decreased healthcare use during an ICU-associated hospitalization.
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