Abstract:
OBJECTIVE:To determine whether it is possible to predict, at the time of hospice enrollment, which patients will die within 6 months. DESIGN:Electronic health record-based retrospective cohort study. SETTING:Patients admitted to 10 hospices in the CHOICE network (Coalition of Hospices Organized to Investigate Comparative Effectiveness). PARTICIPANTS:Hospice patients. MAIN OUTCOME MEASURES:Mortality at 6 months following hospice admission. RESULTS:Among 126,620 patients admitted to 10 hospices, 118,532 (93.6%) died within 6 months. In a multivariable logistic regression model, five characteristics were independent predictors of 6-month mortality. For instance, patients younger than 65 years were less likely to die within 6 months (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.45-0.91; p=0.014). Conversely, male patients were more likely to die within 6 months (OR 1.47; 95% CI 1.05-2.02; p=;0.036). After adjusting for other variables in this model, there were several subgroups with a low probability of 6-month probability (e.g., stroke and Palliative Performance Scale [PPS] score=50; adjusted probability of 6-month mortality=39.4%; 95% CI: 13.9%-72.5%). However, 95% confidence intervals of these 6-month mortality predictions extended above 50%. CONCLUSIONS:Hospices might use several variables to identify patients with a relatively low risk for 6-month mortality and who therefore may become ineligible to continue hospice services if they fail to show significant disease progression.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Harris PS,Stalam T,Ache KA,Harrold JE,Craig T,Teno J,Smither E,Dougherty M,Casarett Ddoi
10.1089/jpm.2013.0631subject
Has Abstractpub_date
2014-08-01 00:00:00pages
894-8issue
8eissn
1096-6218issn
1557-7740journal_volume
17pub_type
杂志文章abstract:BACKGROUND:There is heightened emphasis on teaching end-of-life (EOL) care in the medical school curriculum, but a relative paucity of tools focused on assessing key attitudinal changes due to curricula. OBJECTIVE:We sought to evaluate the responsiveness of two validated measures of relevant attitudes to changes cause...
journal_title:Journal of palliative medicine
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0548
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abstract::Securing a first job following training is an exciting and daunting task. Little formal guidance is available and trainees often find themselves confused, uncertain, and overwhelmed. This article is designed to provide a basic framework for fellows and new graduates to search for positions, apply, interview, and negot...
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abstract:BACKGROUND:Nurses and nursing care providers provide the most direct care to patients at end of life. Yet, evidence indicates that many feel ill-prepared for the complexity of palliative care. OBJECTIVE:To review the resources required to ensure adequate education, training, and mentorship for nurses and nursing care ...
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pub_type: 杂志文章
doi:10.1089/jpm.2017.0395
更新日期:2018-01-01 00:00:00
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journal_title:Journal of palliative medicine
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abstract:INTRODUCTION:Spiritual needs play an important role in palliative care as both a clinical dimension and a therapeutic strategy. However, recent studies have shown that the management of this dimension still remains a challenge at the clinical level of palliative care. GOALS:Our goal was to evaluate the spiritual needs...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0569
更新日期:2014-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1089/jpm.2014.0203
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journal_title:Journal of palliative medicine
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abstract:BACKGROUND:Numerous studies have focused on the treatment of non-small cell lung cancer patients with brain metastases. However, to our knowledge, few have sought to examine outcomes in patients who required whole brain radiation and developed radiation-refractory disease. METHODS:This study examined the medical recor...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0097
更新日期:2015-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1089/jpm.2015.0398
更新日期:2016-07-01 00:00:00
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doi:10.1089/jpm.2016.0545
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pub_type: 杂志文章
doi:10.1089/jpm.2005.8.115
更新日期:2005-02-01 00:00:00
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doi:10.1089/jpm.2011.0069
更新日期:2011-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1089/jpm.2018.0270
更新日期:2018-12-01 00:00:00
abstract:: Background: Many older adults with serious illness who depend on others for care have symptoms that are difficult to manage. Supporting caregivers in symptom assessment (SA) may reduce suffering. Objective: Pilot an SA-Toolkit ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0103
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Although the role of volunteers is at the heart of hospice care, little is known about hospice volunteer training and volunteer activity. METHOD:A survey was used to assess current training programs for hospice volunteers. Hospices were invited to participate in the study from a link on the website for the ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0240
更新日期:2010-03-01 00:00:00
abstract:: Background: Insufficient knowledge of palliative radiotherapy (PRT) among hospice and palliative medicine (HPM) physicians is thought to be a barrier to the provision of high-quality palliative care. Objective: To assess the ne...
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更新日期:2017-01-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1089/jpm.2017.0576
更新日期:2018-07-01 00:00:00
abstract:INTRODUCTION:Most medical schools are remiss in preparing physicians in end-of-life communication skills. As a result, many residents are uncomfortable with approaching the patient, have not developed the skills required to discuss the patients' wishes, and avoid end-of-life conversations. OBJECTIVE:To evaluate an edu...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.964
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Regardless of the payer and the period studied the prevalence of potentially inappropriate medication use in the elderly ranged from 21% to 40%. OBJECTIVE:To look at potentially inappropriate prescribing in a group of Medicare+Choice beneficiaries in their last year of life (LYOL) in a large national manage...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.0215
更新日期:2007-06-01 00:00:00
abstract::The treatment of suffering is now recognized as an essential component of medical care. By referring to this treatment as "palliative care," however, we diminish its importance. In this essay, we propose a shift in our conception of the treatment of suffering and advocate for the use of a new term: "palliative treatme...
journal_title:Journal of palliative medicine
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doi:10.1089/jpm.2009.0410
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Residents struggle with advance care planning (ACP) discussions in the inpatient setting, and may not be aware of newer models for ACP that stress the importance of giving prognostic information and making a recommendation about cardiopulmonary resuscitation to patients and families. METHODS:A controlled st...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1089/jpm.2010.0383
更新日期:2011-03-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0171
更新日期:2019-11-01 00:00:00
abstract:: Background: Mobile health (mHealth) is a promising tool for improving health outcomes. However, the benefits of using mHealth in palliative care are under studied. Objective: As a first step to designing meaningful palliative c...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0216
更新日期:2020-02-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,meta分析,评审
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更新日期:2013-04-01 00:00:00