Evidence map›Paper›PMID 39180221›Full record

ArticleJournal of the American Geriatrics Society2024

Veterans' use of inpatient and outpatient palliative care: The national landscape.

Brystana G Kaufman, Sandra Woolson, Catherine Stanwyck, Madison Burns, Paul Dennis, Jessica Ma, Shelli Feder, Joshua M Thorpe, S Nicole Hastings, David B Bekelman and 1 more

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Multi-Level Factors Impacting Implementation of Outpatient Palliative Care: Perceptions of VA Providers.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Brystana G KaufmanCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.ORCID https://orcid.org/0000-0001-6553-0406
Sandra WoolsonCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.
Catherine StanwyckCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.
Madison BurnsCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.
Paul DennisCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.
Jessica MaGeriatric Research, Education, and Clinical Center, Durham VA Health System, Durham, North Carolina, USA.
Shelli FederYale University School of Nursing, Orange, Connecticut, USA.ORCID https://orcid.org/0000-0002-8059-9281
Joshua M ThorpeCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
S Nicole HastingsCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.
David B BekelmanDepartment of Veterans Affairs, Department of Medicine, Eastern Colorado Health Care System, Aurora, Colorado, USA.
Courtney H Van HoutvenCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Outpatient Palliative Care Implementation to Improve Outcomes for AgingVeteransIK2HX003244 · VA · DURHAM VA MEDICAL CENTER · PI Brystana G. Kaufman · 2022 to 2026
–
Health Services Research and Development 20-032HSRD VA CIN 13-410HSRD VA IK2 HX003244HSRD VA QUE 16-170NCATS NIH HHS UL1 TR001863Quality Enhancement Research Initiative QUE-16-170
6 · The paper itself

Abstract

backgroundPalliative care improves the quality of life for people with life-limiting conditions, which are common among older adults. Despite the Veterans Health Administration (VA) outpatient palliative care expansion, most research has focused on inpatient palliative care. This study aimed to compare veteran characteristics and hospice use for palliative care users across care settings (inpatient vs. outpatient) and dose (number of palliative care encounters).

methodsThis national cohort included veterans with any VA palliative care encounters from 2014 through 2017. We used VA and Medicare administrative data (2010-2017) to describe veteran demographics, socioeconomic status, life-limiting conditions, frailty, and palliative care utilization. Specialty palliative care encounters were identified using clinic stop codes (353, 351) and current procedural terminology codes (99241-99245).

resultsOf 120,249 unique veterans with specialty palliative care over 4 years, 67.8% had palliative care only in the inpatient setting (n = 81,523) and 32.2% had at least one palliative care encounter in the outpatient setting (n = 38,726), with or without an inpatient palliative care encounter. Outpatient versus inpatient palliative care users were more likely to have cancer and less likely to have high frailty, but sociodemographic factors including rurality and housing instability were similar. Duration of hospice use was similar between inpatient (median = 37 days; IQR = 11, 112) and outpatient (median = 44 days; IQR = 14, 118) palliative care users, and shorter among those with only one palliative care encounter (median = 18 days; IQR = 5, 64).

conclusionsThis national evaluation provides novel insights into the care setting and dose of VA specialty palliative care for veterans. Among veterans with palliative care use, one-third received at least some palliative care in the outpatient care setting. Differences between veterans with inpatient and outpatient use motivate the need for further research to understand how care settings and number of palliative care encounters impact outcomes for veterans and older adults.

Indexed as

Ambulatory CarePalliative CareUnited States Department of Veterans AffairsVeteransAgedAged, 80 and overCohort StudiesFemaleHospice CareHospitalizationHumansInpatientsMaleMedicareMiddle AgedUnited Statesend‐of‐life carehealth services researchhospicepalliative careveterans

Identifiers

PMID39180221
PMCPMC11580742

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.