Integrative Palliative Care,Advance Directives,and Hospital Outcomes of Critically Ill Older Adults

Abstract

Objective:

To examine the associations between palliative care types and hospital outcomes for patients who have or do not have advance directives.

Method:

Using administrative claims and clinical data for critically ill older adults (n = 1291), multivariable regressions examined the associations between palliative care types and hospital outcomes by advance directive status.

Results:

Integrative palliative care was associated with lower hospital costs, lower adjusted probability of in-hospital deaths, and higher adjusted probability of hospice discharges. There was no difference in hospital outcomes by palliative care types in those with advance directives.

Conclusion:

Significantly lower hospital costs and in-hospital deaths with higher hospice discharges were observed in integrative palliative care compared to consultative palliative care, but these findings were diminished with the presence of advance directives.

Keywords

critical care health services for the aged palliative care integrative medicine advance directives hospital costs in-hospital mortality hospice care

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