ArticleJournal of the American College of Emergency Physicians open2025
Benefits of Emergency Department-Initiated Goals of Care Conversations and Palliative Care Consultations Among Older Adults with Chronic or Serious Life-Limiting Illnesses.
Article in Journal of the American College of Emergency Physicians open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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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.
Who cites it
1 citing paper in PubMed.
- Core Elements of Goals of Care Initiatives Across Eight Health Systems.Journal of pain and symptom management · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: For older adults with serious illnesses, delaying goals of care (GOC) discussions until admission may worsen unmet palliative needs and increase costly interventions. We compared emergency department (ED) versus inpatient GOC conversations and palliative consultations and their impact on outcomes and cost savings. Methods: We analyzed records (July 2021-June 2023) of patients ≥65 years old admitted from our suburban level 1 trauma and quaternary care hospital. Included patients received a GOC conversation or palliative consultation in the ED or inpatient settings. We excluded patients discharged from the ED, directly admitted, or expired in the ED. Primary outcome: total length of stay (LOS). Secondary outcomes: intensive care unit (ICU) days, excess days in acute care (EDAC), contribution margin, and hospice discharge odds. Multivariable regression models assessed differences in outcomes in ED versus inpatient conversations and palliative consultations. Results: A total of 7326 patients received a GOC conversation (18.1% ED). A total of 2976 received a palliative consultation (8.1% ED). Adjusting for age, race, ethnicity, case mix index, and admission source, ED-initiated GOC conversations were associated with reduced total LOS (β = -2.82 days, 95% CI: -3.50, -2.15), fewer EDAC (β = -2.72 days, 95% CI: -3.40, -2.03), and increased contribution margin (β = $2689, 95% CI: $1214, $4165). ED-initiated palliative consultations were associated with reduced total LOS (β = -6.73 days, 95% CI: -8.66, -4.81), fewer EDAC (β = -6.05 days, 95% CI: -7.99, -4.10), fewer ICU days (β = -0.98 days, 95% CI: -1.68, -0.27), and increased hospice discharge odds (odds ratio: 1.59, 95% CI: 1.14, 2.22). Conclusion: ED-initiated GOC conversations and palliative consultations among older adults are associated with improved outcomes and increased cost savings.
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Registered trials
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