Predictors of Placement of Inpatient Palliative Care Consult Orders Among Patients With Breast, Lung, and Colon Cancer in a Safety Net Hospital System

Smith, Lauren; Rhodes, Ramona L.; Liu, Xuan; Halm, Ethan A.

doi:10.1177/1049909117733473

Cited by 7 publications

(5 citation statements)

References 19 publications

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“…Table 1 reports more recent detail of studies that conducted between 2015 and 2020 on advance healthcare planning and directives, palliative and hospice care that exclusively focused on or included non-Hispanic Blacks. 147,148,150 Palliative and Hospice Care…”

Section: Methodsmentioning

confidence: 99%

Disparities in Palliative and Hospice Care and Completion of Advance Care Planning and Directives Among Non-Hispanic Blacks: A Scoping Review of Recent Literature

Bazargan

Bazargan‐Hejazi

2020

Am J Hosp Palliat Care

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Objectives: Published research in disparities in advance care planning, palliative, and end-of-life care is limited. However, available data points to significant barriers to palliative and end-of-life care among minority adults. The main objective of this scoping review was to summarize the current published research and literature on disparities in palliative and hospice care and completion of advance care planning and directives among non-Hispanc Blacks. Methods: The scoping review method was used because currently published research in disparities in palliative and hospice cares as well as advance care planning are limited. Nine electronic databases and websites were searched to identify English-language peer-reviewed publications published within last 20 years. A total of 147 studies that addressed palliative care, hospice care, and advance care planning and included non-Hispanic Blacks were incorporated in this study. The literature review include manuscripts that discuss the intersection of social determinants of health and end-of-life care for non-Hispanic Blacks. We examined the potential role and impact of several factors, including knowledge regarding palliative and hospice care; healthcare literacy; communication with providers and family; perceived or experienced discrimination with healthcare systems; mistrust in healthcare providers; health care coverage, religious-related activities and beliefs on palliative and hospice care utilization and completion of advance directives among non-Hispanic Blacks. Discussion: Cross-sectional and longitudinal national surveys, as well as local community- and clinic-based data, unequivocally point to major disparities in palliative and hospice care in the United States. Results suggest that national and community-based, multi-faceted, multi-disciplinary, theoretical-based, resourceful, culturally-sensitive interventions are urgently needed. A number of practical investigational interventions are offered. Additionally, we identify several research questions which need to be addressed in future research.

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Section: Methodsmentioning

confidence: 99%

Disparities in Palliative and Hospice Care and Completion of Advance Care Planning and Directives Among Non-Hispanic Blacks: A Scoping Review of Recent Literature

Bazargan

Bazargan‐Hejazi

2020

Am J Hosp Palliat Care

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“…First, most studies examined outcomes for people who were White, suggesting that this population may have been used as a comparator group. This approach has been criticized for centering Whiteness and placing many diverse groups within the Other [ 178 ] and perpetuating a broader system where White race is considered normative, and outcomes for individual racialized groups are obscured [ 218 ]. While White, Black, Hispanic/LatinX groups were examined in more than 50% of citations, others –– including Turtle Island (North American) Indigenous, Aboriginal Australian, Asian (multiple groups), Asian/Pacific Islander, Mixed, Māori, South Asian, East Asian, and Southeast Asian – were named in 25% or fewer studies.…”

Section: Discussionmentioning

confidence: 99%

Naming racism as a root cause of inequities in palliative care research: a scoping review

Algu,

Wales,

Anderson

et al. 2024

BMC Palliat Care

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Background Racial and ethnic inequities in palliative care are well-established. The way researchers design and interpret studies investigating race- and ethnicity-based disparities has future implications on the interventions aimed to reduce these inequities. If racism is not discussed when contextualizing findings, it is less likely to be addressed and inequities will persist. Objective To summarize the characteristics of 12 years of academic literature that investigates race- or ethnicity-based disparities in palliative care access, outcomes and experiences, and determine the extent to which racism is discussed when interpreting findings. Methods Following Arksey & O’Malley’s methodology for scoping reviews, we searched bibliographic databases for primary, peer reviewed studies globally, in all languages, that collected race or ethnicity variables in a palliative care context (January 1, 2011 to October 17, 2023). We recorded study characteristics and categorized citations based on their research focus—whether race or ethnicity were examined as a major focus (analyzed as a primary independent variable or population of interest) or minor focus (analyzed as a secondary variable) of the research purpose, and the interpretation of findings—whether authors directly or indirectly discussed racism when contextualizing the study results. Results We identified 3000 citations and included 181 in our review. Of these, most were from the United States (88.95%) and examined race or ethnicity as a major focus (71.27%). When interpreting findings, authors directly named racism in 7.18% of publications. They were more likely to use words closely associated with racism (20.44%) or describe systemic or individual factors (41.44%). Racism was directly named in 33.33% of articles published since 2021 versus 3.92% in the 10 years prior, suggesting it is becoming more common. Conclusion While the focus on race and ethnicity in palliative care research is increasing, there is room for improvement when acknowledging systemic factors – including racism – during data analysis. Researchers must be purposeful when investigating race and ethnicity, and identify how racism shapes palliative care access, outcomes and experiences of racially and ethnically minoritized patients.

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“…Evidence in support of early palliative care involvement has built a strong base, with studies showing that those who receive earlier intervention from palliative care have lower rates of hospitalizations. 5,8 For patients with advanced cancer, palliative care has been shown to improve health outcomes, positively impact quality of life, 5,7 reduce rates of depression, 5,7 decrease racial/ethnic disparities in hospice enrollment, 9 and result in better overall survival rates. 5 Similarly, data have shown that palliative care is associated with lower healthcare utilization at the end-of-life.…”

Section: Discussion Limitations and Future Directionsmentioning

confidence: 99%

“…These patients were hospitalized at Parkland Hospital from January 2010 to December 2010. Data were initially collected via an electronic medical record (EMR) review for a larger clinical study, 6,7 in which patients were identified from the EMR by ICD-9 codes. The investigators relied on data that could be extracted from discrete fields within the EMR; consequently, data on stage of disease were not available.…”

Section: Methodsmentioning

confidence: 99%

Examining the Association between Healthcare Utilization and Clinical Characteristics among Cancer Patients in a Safety Net Health System

Knox-Rice

Liu²,

Wadsworth

et al. 2019

Journal of Palliative Medicine

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Objective-The goal of this study was to examine the association between available patient and clinical characteristics and healthcare utilization in a cohort of breast, lung, and colorectal cancer patients within a safety-net hospital system. Methods-Data for 979 breast, lung, and colorectal cancer patients admitted to a large, urban hospital for the year 2010 were extracted from the electronic medical record (EMR). Univariate and multivariate logistic regression analyses were performed to examine the association between relevant independent variables that were able to be captured from the EMR in discrete fields, emergency room (ER) utilization, and hospitalizations among members of the cohort. Spearman correlation coefficients to test the correlations between nonsteroidal anti-inflammatory drug and opioid prescriptions and healthcare utilization were also calculated. Results-Of the 979 patients, 22% were 65 years and older, 43% were non-Hispanic black, 42% had Medicare, and 56% had colorectal cancer. Patient and clinical characteristics that were associated with increased ER utilization, included Hispanic ethnicity

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Predictors of Placement of Inpatient Palliative Care Consult Orders Among Patients With Breast, Lung, and Colon Cancer in a Safety Net Hospital System

Abstract: In this cohort of patients in a safety net hospital, markers of pain, advanced disease, and poor prognosis were associated with placement of inpatient palliative care consult orders.

Cited by 7 publications

References 19 publications

Disparities in Palliative and Hospice Care and Completion of Advance Care Planning and Directives Among Non-Hispanic Blacks: A Scoping Review of Recent Literature

Disparities in Palliative and Hospice Care and Completion of Advance Care Planning and Directives Among Non-Hispanic Blacks: A Scoping Review of Recent Literature

Naming racism as a root cause of inequities in palliative care research: a scoping review

Examining the Association between Healthcare Utilization and Clinical Characteristics among Cancer Patients in a Safety Net Health System

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