Australasian haematologist referral patterns to palliative care: lack of consensus on when and why

Auret, Kirsten; Bulsara, Caroline; Joske, David

doi:10.1111/j.1445-5994.2003.00490.x

Cited by 66 publications

(77 citation statements)

References 12 publications

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“…24,25 This makes it difficult to identify natural transitions to palliative goals of care. 26,27 In addition to these three primary findings, several other patient characteristics were identified that were independently associated with late hospice enrollment. These include male sex, comorbidities, and nonwhite ethnicity.…”

Section: Discussionmentioning

confidence: 94%

Hospice Admissions for Cancer in the Final Days of Life: Independent Predictors and Implications for Quality Measures

O’Connor

Harris

et al. 2014

JCO

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Purpose To define patient characteristics associated with hospice enrollment in the last 3 days of life, and to describe adjusted proportions of patients with late referrals among patient subgroups that could be considered patient-mix adjustment variables for this quality measure. Methods Electronic health record–based retrospective cohort study of patients with cancer admitted to 12 hospices in the Coalition of Hospices Organized to Investigate Comparative Effectiveness network. Results Of 64,264 patients admitted to hospice with cancer, 10,460 (16.3%) had a length of stay ≤ 3 days. There was significant variation among hospices (range, 11.4% to 24.5%). In multivariable analysis, among patients referred to hospice, patients who were admitted in the last 3 days of life were more likely to have a hematologic malignancy, were more likely to be male and married, and were younger (age < 65 years). Patients with Medicaid or self-insurance were less likely to be admitted to hospice within 3 days of death. Conclusion Quality measures of hospice lengths of stay should include patient-mix adjustments for type of cancer and site of care. Patients with hematologic malignancies are at especially increased risk for late admission to hospice.

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Section: Discussionmentioning

confidence: 94%

Hospice Admissions for Cancer in the Final Days of Life: Independent Predictors and Implications for Quality Measures

O’Connor

Harris

et al. 2014

JCO

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“…However, surveys of clinicians have identified a willingness to refer such patients and engage more actively with palliative care. 23 In order to improve collaboration with hematology, palliative care services must also be proactive and flexible. 24 The impact of palliative care services among patients was reflected in the fivefold lower proportion of inpatient deaths occurring in ICU that had been previously referred to palliative care.…”

Section: Increasing Hematology Referrals To Palliative Carementioning

confidence: 99%

Palliative Care and Hematological Malignancies: Increased Referrals at a Comprehensive Cancer Centre

Corbett

Johnstone

Trauer

et al. 2013

Journal of Palliative Medicine

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“…10 The decision to delay the transition from a curative to a palliative strategy until a very late stage of the disease is particularly realistic for the hematological setting, where malignancies are so persistently sensitive to innovative treatment strategies that end-oflife care is ineffectual or not offered at all. [11][12][13] This is why we have also included in our HC program the group of patients in advanced phase of their disease with an expected median survival of more than 3 months.…”

Section: Discussionmentioning

confidence: 99%

Cost analysis of a domiciliary program of supportive and palliative care for patients with hematologic malignancies

Cartoni¹,

Brunetti²,

D’Elia³

et al. 2007

Haematologica

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The costs of home care (HC) programs may be tailored to the specific needs of patients with hematological malignancies. The aim of this study was to analyze the use of resources and the costs of a program of HC for four different prognostic groups of patients subdivided according to disease status. Over 2 years, 144 patients with hematological malignancies were assisted at home. Patients were subdivided according to disease status and life expectancy in the following groups: (i) terminal phase, with a life expectancy of 3 months or less; (ii) advanced phase, with a life expectancy of 6 months or less; (iii) chronic phase, with a life expectancy of more than 6 months; (iv) discharged early from the hospital with curable disease, following anticancer chemotherapy. Median mean monthly costs (MMC) in Euro (€) have been compared with the costs of hospitalization (DRG). Among the 4 groups of patients, those discharged early and in terminal phase required the highest mean monthly number of home visits (27.2 and 24.1), transfusions (6.1 and 6.8) and days of care (22.8 and 19.7) respectively. MMC were affected by the following variables: disease status and transfusion requirements. MMC for terminal patients (4,232.50€) and those discharged early (3,986.40€) were higher than those for advanced (2,303.80€) and chronic patients (1,488,30€). The cost of HC was lower than the corresponding DRG charges, but exceeded the district fares for HC of cancer patients. In hematological patients, the costs of HC differ according to disease status and transfusion requirements. For some categories of patients, costs of HC are lower than those of hospitalization, although higher than the current national fares for HC programs. ©2007 Ferrata Storti Foundation

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Australasian haematologist referral patterns to palliative care: lack of consensus on when and why

Abstract: In theory there is a willingness to refer to palliative care, however this has yet to be translated to day-to-day practice. This may be due to prognostication difficulties, logistical factors and medical concerns. Models of referral are suggested for further study.

Cited by 66 publications

References 12 publications

Hospice Admissions for Cancer in the Final Days of Life: Independent Predictors and Implications for Quality Measures

Hospice Admissions for Cancer in the Final Days of Life: Independent Predictors and Implications for Quality Measures

Palliative Care and Hematological Malignancies: Increased Referrals at a Comprehensive Cancer Centre

Cost analysis of a domiciliary program of supportive and palliative care for patients with hematologic malignancies

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