Can hospices predict which patients will die within six months?

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 Med

authors

Harris PS,Stalam T,Ache KA,Harrold JE,Craig T,Teno J,Smither E,Dougherty M,Casarett D

doi

10.1089/jpm.2013.0631

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

894-8

issue

8

eissn

1096-6218

issn

1557-7740

journal_volume

17

pub_type

杂志文章
  • Detecting attitudinal changes about death and dying as a result of end-of-life care curricula for medical undergraduates.

    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

    pub_type: 杂志文章

    doi:10.1089/jpm.2005.8.975

    authors: Schwartz CE,Clive DM,Mazor KM,Ma Y,Reed G,Clay M

    更新日期:2005-10-01 00:00:00

  • End-of-Life Medical Treatments in the Last Two Weeks of Life in Palliative Care Units in Japan, 2005-2006: A Nationwide Retrospective Cohort Survey.

    abstract:BACKGROUND:Comprehensive information on end-of-life care in specialized palliative care settings is needed to assess the quality of care. OBJECTIVE:This study aimed to investigate medical treatments in the last two weeks of life in a national sample of palliative care units in Japan. DESIGN:Retrospective cohort study...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2016.0108

    authors: Sato K,Miyashita M,Morita T,Tsuneto S,Shima Y

    更新日期:2016-11-01 00:00:00

  • Post-Traumatic Stress Disorder Symptoms from Multiple Stressors Predict Chronic Pain in Cancer Survivors.

    abstract:: Background: Despite the association between chronic pain and post-traumatic stress disorder (PTSD), little is known about the longitudinal course of pain and PTSD during cancer treatment. Objectives: We examined the prevalence ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0458

    authors: Sager ZS,Wachen JS,Naik AD,Moye J

    更新日期:2020-09-01 00:00:00

  • Birth Planning in Uncertain or Life-Limiting Fetal Diagnoses: Perspectives of Physicians and Parents.

    abstract:: Background: Providers often use birth plans to document parents' wishes for their fetus with a life-limiting condition. Objective: The objective of the study was to (1) discover important components of a birth plan for parents ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2018.0596

    authors: Cortezzo DE,Bowers K,Cameron Meyer M

    更新日期:2019-11-01 00:00:00

  • Evaluating the Economic Impact of Palliative and End-of-Life Care Interventions on Intensive Care Unit Utilization and Costs from the Hospital and Healthcare System Perspective.

    abstract::Purpose of report: Understanding the impact of palliative care interventions on intensive care unit (ICU) costs and utilization is critical for demonstrating the value of palliative care. Performing these economic assessments, however, can be challenging. The purpose of this special report is to highlight and discuss ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2016.0548

    authors: Khandelwal N,Brumback LC,Halpern SD,Coe NB,Brumback B,Curtis JR

    更新日期:2017-12-01 00:00:00

  • Strategies for finding and negotiating a first position in hospice and palliative medicine.

    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...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2010.0002

    authors: Weckmann MT,Block S

    更新日期:2010-09-01 00:00:00

  • Resources for Educating, Training, and Mentoring Nurses and Unregulated Nursing Care Providers in Palliative Care: A Review and Expert Consultation.

    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 ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2017.0395

    authors: Pesut B,Greig M

    更新日期:2018-01-01 00:00:00

  • Directly observed patient-physician discussions in palliative and end-of-life care: a systematic review of the literature.

    abstract:OBJECTIVES:To review studies that used direct observation (i.e., videotaping or audiotaping) methods in palliative/end-of-life care communication research. DESIGN:Descriptive thematic analysis. SETTING:Multinational studies were conducted in both the outpatient and inpatient setting. MEASUREMENTS:Extensive bibliogra...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2009.0388

    authors: Fine E,Reid MC,Shengelia R,Adelman RD

    更新日期:2010-05-01 00:00:00

  • Evaluation of spiritual needs of patients with advanced cancer in a palliative care unit.

    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

    authors: Vilalta A,Valls J,Porta J,Viñas J

    更新日期:2014-05-01 00:00:00

  • Assessing End-of-Life Care across Settings in an Integrated Health Care Delivery System.

    abstract:: Objective: To systematically capture patient- and family-centered data to understand variability and opportunities in end-of-life care delivery across settings in an integrated health care delivery system. Background: Improving...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0265

    authors: Wang MC,Johnson D,Glass D,Martel H,Mularski RA,Bellows J

    更新日期:2020-06-01 00:00:00

  • Is physician awareness of impending death in hospital related to better communication and medical care?

    abstract:BACKGROUND:In hospitals, where care is focused on cure and life prolongation, impending death is often recognized too late. Physician awareness of impending death is a prerequisite for communication with patients and relatives about dying in hospital and providing care that adequately addresses patients' needs. OBJECT...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2014.0203

    authors: Houttekier D,Witkamp FE,van Zuylen L,van der Rijt CC,van der Heide A

    更新日期:2014-11-01 00:00:00

  • Percutaneous cervical cordotomy for the management of pain from cancer: a prospective review of 45 cases.

    abstract:BACKGROUND:Percutaneous cervical cordotomy (PCC) is a well recognized but infrequently performed procedure for the relief of unilateral intractable pain from malignancy. There is a paucity of data regarding efficacy and safety of PCC. OBJECTIVES:The study's objectives were to demonstrate the efficacy and safety of PCC...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2013.0027

    authors: Bain E,Hugel H,Sharma M

    更新日期:2013-08-01 00:00:00

  • Radiation-Refractory Brain Metastases in Patients with Non-Small Cell Lung Cancer.

    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

    authors: Spiceland CM,Olivier KR,Jatoi A

    更新日期:2015-08-01 00:00:00

  • Why the Interdisciplinary Team Approach Works: Insights from Complexity Science.

    abstract:BACKGROUND:Although an interdisciplinary approach is considered best practice for caring for patients at the end of life, or in need of palliative care (PC) services, there is growing tension between healthcare organizations' need to contain costs and the provision of this beneficial, yet resource-intensive service. O...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2015.0398

    authors: Ciemins EL,Brant J,Kersten D,Mullette E,Dickerson D

    更新日期:2016-07-01 00:00:00

  • Seeking and Accepting: U.S. Clergy Theological and Moral Perspectives Informing Decision Making at the End of Life.

    abstract:BACKGROUND:People with serious illness frequently rely on religion/spirituality to cope with their diagnosis, with potentially positive and negative consequences. Clergy are uniquely positioned to help patients consider medical decisions at or near the end of life within a religious/spiritual framework. OBJECTIVE:We a...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2016.0545

    authors: Sanders JJ,Chow V,Enzinger AC,Lam TC,Smith PT,Quiñones R,Baccari A,Philbrick S,White-Hammond G,Peteet J,Balboni TA,Balboni MJ

    更新日期:2017-10-01 00:00:00

  • Who enrolls in observational end of life research? Report from the cultural variations in approaches to end of life study.

    abstract:BACKGROUND:Response bias in end of life research is important though not well understood. OBJECTIVES:To compare consenting advanced cancer patient participants and refusers in observational end of life research. We hypothesized that, compared with refusers, consenters would: 1) have a stronger belief in personal gain ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2005.8.115

    authors: Phipps E,Harris D,Braitman LE,Tester W,Madison-Thompson N,True G

    更新日期:2005-02-01 00:00:00

  • Development of the Palliative Care Parental Self-Efficacy Measure.

    abstract::Caring for a child with a potentially fatal medical condition is a challenge for parents or caregivers. The ability to measure parental self-efficacy in pediatric palliative care may be an important component of targeting supportive services that address individual needs of families. Therefore, the goal was to develop...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2011.0069

    authors: Bingen K,Kupst MJ,Himelstein B

    更新日期:2011-09-01 00:00:00

  • Identifying Connectional Silence in Palliative Care Consultations: A Tandem Machine-Learning and Human Coding Method.

    abstract:: Background: Systematic measurement of conversational features in the natural clinical setting is essential to better understand, disseminate, and incentivize high quality serious illness communication. Advances in machine-learning (ML) classification of human speech offer ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2018.0270

    authors: Durieux BN,Gramling CJ,Manukyan V,Eppstein MJ,Rizzo DM,Ross LM,Ryan AG,Niland MA,Clarfeld LA,Alexander SC,Gramling R

    更新日期:2018-12-01 00:00:00

  • Supporting In-Home Caregivers in Symptom Assessment of Frail Older Adults with Serious Illness: A Pilot Study.

    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

    authors: Nouri S,Ritchie C,Chen P,Volow A,Li B,Tellez I,Sudore RL

    更新日期:2020-12-01 00:00:00

  • Results from the national hospice volunteer training survey.

    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

    authors: Wittenberg-Lyles E,Schneider G,Oliver DP

    更新日期:2010-03-01 00:00:00

  • Palliative Radiotherapy Education for Hospice and Palliative Medicine Fellows: A National Needs Assessment.

    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...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0118

    authors: Martin EJ,Jones JA

    更新日期:2020-02-01 00:00:00

  • Feasibility Testing of an Emergency Department Screening Tool To Identify Older Adults Appropriate for Palliative Care Consultation.

    abstract:BACKGROUND:Seriously ill older adults in the emergency department (ED) may benefit from palliative care referral, yet little is known about how to identify these patients. OBJECTIVES:To assess the performance and determine the acceptability of a content-validated palliative care screening tool. DESIGN:We surveyed Eme...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2016.0213

    authors: Ouchi K,Block SD,Schonberg MA,Jamieson ES,Aaronson EL,Pallin DJ,Tulsky JA,Schuur JD

    更新日期:2017-01-01 00:00:00

  • Psychotherapy Targeting Depression and Anxiety for Use in Palliative Care: A Meta-Analysis.

    abstract:BACKGROUND:Research on the effectiveness of evidence-based practices in the treatment of depression and anxiety with palliative care populations is primarily limited to individuals having specific conditions such as cancer. OBJECTIVE:This meta-analysis examined the effect of psychotherapy on depression and anxiety amo...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1089/jpm.2017.0576

    authors: Fulton JJ,Newins AR,Porter LS,Ramos K

    更新日期:2018-07-01 00:00:00

  • Evaluation of an educational intervention to encourage advance directive discussions between medicine residents and patients.

    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

    authors: Furman CD,Head B,Lazor B,Casper B,Ritchie CS

    更新日期:2006-08-01 00:00:00

  • Potentially inappropriate medication use by Medicaid+Choice beneficiaries in the last year of life.

    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

    authors: Fahlman C,Lynn J,Finch M,Doberman D,Gabel J

    更新日期:2007-06-01 00:00:00

  • Palliative treatment: redefining interventions to treat suffering near the end of life.

    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

    pub_type: 杂志文章

    doi:10.1089/jpm.2009.0410

    authors: Kon AA,Ablin AR

    更新日期:2010-06-01 00:00:00

  • Development of a cognitive model for advance care planning discussions: results from a quality improvement initiative.

    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

    authors: Jacobsen J,Robinson E,Jackson VA,Meigs JB,Billings JA

    更新日期:2011-03-01 00:00:00

  • Managing Cancer Pain, Monitoring for Cancer Recurrence, and Mitigating Risk of Opioid Use Disorders: A Team-Based, Interdisciplinary Approach to Cancer Survivorship.

    abstract:: Background: Palliative care (PC) teams increasingly care for patients with cancer into survivorship. Cancer survivorship transcends distinctions between acute, chronic, malignant, and nonmalignant pain. Partnering with oncologists, PC teams manage pain that persists after ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0171

    authors: Goodlev ER,Discala S,Darnall BD,Hanson M,Petok A,Silverman M

    更新日期:2019-11-01 00:00:00

  • "We're Taking Something So Human and Trying to Digitize": Provider Recommendations for mHealth in Palliative Care.

    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

    authors: Dickman Portz J,Ford K,Bekelman DB,Boxer RS,Kutner JS,Czaja S,Elsbernd K,Bull S

    更新日期:2020-02-01 00:00:00

  • Continuity, coordination, and transitions of care for patients with serious and advanced illness: a systematic review of interventions.

    abstract:OBJECTIVES:Continuity, coordination, and transitions of care are key to high-quality medical care for patients with serious and advanced illness. We conducted a systematic review to evaluate the impact of interventions targeting these areas in this population. METHODS:We searched PubMed, CINAHL, PsycINFO, Cochrane, an...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1089/jpm.2012.0317

    authors: Dy SM,Apostol C,Martinez KA,Aslakson RA

    更新日期:2013-04-01 00:00:00