Impact of Inpatient Palliative Care on Treatment Intensity for Patients with Serious Illness

Horton, Jay R.; Morrison, R. Sean; Capezuti, Elizabeth; Hill, Jennifer; Lee, Eric J.; Kelley, Amy S.

doi:10.1089/jpm.2015.0240

“…In a retrospective study, Hua et al, found that patients in the intervention and control group experienced the same length of stay (6 days) but patients in the intervention group were 46% more likely to be discharged to a hospice [76]. These findings are supported by those of Horton et al [77].…”

Section: A; Innovations Supporting Early Hospital Dischargementioning

confidence: 83%

“…A total of 1252 abstracts were reviewed by one author, resulting in the identification of ten categories of initiatives grouped under three broad headings (Fig. 1, Table 1): 1;'Facilitating entry into the hospice and community care system' [27], 2a-2 g; 'Preventing admission' and 3a&3b; 'Facilitating discharge' (Table 1) [56,66,72,[75][76][77][78]. Classification was reviewed by a second author.…”

Section: Partmentioning

confidence: 99%

“…[56,74] 3 Facilitate discharge 3a; Hospital or emergency department-based discharge service Patients requesting or considered suitable for discharge into supported care (community, nursing home, hospice) are identified by a hospital-based doctor or nurse who facilitates onward management. [56,66,72,[75][76][77] 3b; Nurse-led palliative care inpatient capacity expansion Offering additional nurse-led beds for less complex patients.…”

Section: Part 2 Overviewmentioning

confidence: 99%

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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

Taylor

¹

,

Ellis

²

,

Gao

³

et al. 2020

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Background: Hospitalisation during the last weeks of life when there is no medical need or desire to be there is distressing and expensive. This study sought palliative care initiatives which may avoid or shorten hospital stay at the end of life and analysed their success in terms reducing bed days. Methods: Part 1 included a search of literature in PubMed and Google Scholar between 2013 and 2018, an examination of governmental and organisational publications plus discussions with external and co-author experts regarding other sources. This initial sweep sought to identify and categorise relevant palliative care initiatives. In Part 2, we looked for publications providing data on hospital admissions and bed days for each category. Results: A total of 1252 abstracts were reviewed, resulting in ten broad classes being identified. Further screening revealed 50 relevant publications describing a range of multi-component initiatives. Studies were generally small and retrospective. Most researchers claim their service delivered benefits. In descending frequency, benefits identified were support in the community, integrated care, out-of-hours telephone advice, care home education and telemedicine. Nurses and hospices were central to many initiatives. Barriers and factors underpinning success were rarely addressed. Conclusions: A wide range of initiatives have been introduced to improve end-of-life experiences. Formal evidence supporting their effectiveness in reducing inappropriate/non-beneficial hospital bed days was generally limited or absent.

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“…In a retrospective study, Hua et al, found that patients in the intervention and control group experienced the same length of stay (six days) but patients in the intervention group were 46% more likely to be discharged to a hospice (76). These findings are supported by those of Horton et al (77).…”

Section: A; Innovations Supporting Early Hospital Dischargementioning

confidence: 83%

A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admission and bed days in people nearing the end of their life: Much innovation but limited supporting evidence

Taylor

¹

,

Ellis

²

,

Gao

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Objectives Hospitalisation during the last weeks of life when there is no medical need or desire to be there is distressing and expensive. This study sought palliative care initiatives which may avoid or shorten hospital stay at the end of life and analysed their success in terms reducing bed days. Methods Part 1 included a search of literature in PubMed and Google Scholar between 2013 and 2018, an examination of governmental and organisational publications plus discussions with external and co-author experts regarding other sources. This initial sweep sought to identify and categorise relevant palliative care initiatives. In Part 2, we looked for publications providing data on hospital admissions and bed days for each category. Results A total of 1252 abstracts were reviewed, resulting in ten broad classes being identified. Further screening revealed 50 relevant publications describing a range of multi-component initiatives. Studies were generally small and retrospective. Most researchers claim their service delivered benefits. In descending frequency, benefits identified were support in the community, integrated care, out-of-hours telephone advice, care home education and telemedicine. Nurses and hospices were central to many initiatives. Barriers and factors underpinning success were rarely addressed. Conclusions A wide range of initiatives have been introduced to improve end-of-life experiences. Formal evidence supporting their effectiveness in reducing inappropriate/non-beneficial hospital bed days was generally limited or absent.

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“…'Facilitating discharge' (Table 1) (56,66,72,(75)(76)(77)(78). Classification was reviewed by a second author.…”

Section: Partmentioning

confidence: 99%

A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admission and bed days in people nearing the end of their life: Much innovation but limited supporting evidence

Taylor

¹

,

Ellis

²

,

Gao

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Objectives Hospitalisation during the last weeks of life when there is no medical need or desire to be there is distressing and expensive. This study sought palliative care initiatives which may avoid or shorten hospital stay at the end of life and analysed their success in terms reducing bed days. Methods Part 1 included a search of literature in PubMed and Google Scholar between 2013 and 2018, an examination of governmental and organisational publications plus discussions with external and co-author experts regarding other sources. This initial sweep sought to identify and categorise relevant palliative care initiatives. In Part 2, we looked for publications providing data on hospital admissions and bed days for each category. Results A total of 1252 abstracts were reviewed, resulting in ten broad classes being identified. Further screening revealed 50 relevant publications describing a range of multi-component initiatives. Studies were generally small and retrospective. Most researchers claim their service delivered benefits. In descending frequency, benefits identified were support in the community, integrated care, out-of-hours telephone advice, care home education and telemedicine. Nurses and hospices were central to many initiatives. Barriers and factors underpinning success were rarely addressed. Conclusions A wide range of initiatives have been introduced to improve end-of-life experiences. Formal evidence supporting their effectiveness in reducing inappropriate/non-beneficial hospital bed days was generally limited or absent.

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Impact of Inpatient Palliative Care on Treatment Intensity for Patients with Serious Illness

Cited by 27 publications

References 49 publications

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

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

A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admission and bed days in people nearing the end of their life: Much innovation but limited supporting evidence

A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admission and bed days in people nearing the end of their life: Much innovation but limited supporting evidence

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