Comparison of Early Versus Late Palliative Care Consultation in End-of-Life Care for the Hospitalized Frail Elderly Patients

Abstract

To examine the effects of early palliative care (PC; EPC; ≤3 days after admission) consultation versus late PC (>3 days) on number of days from day of consult to discharge (DCDAYS), a retrospective review of PC data (2009-2012) included 531 patients with age ≥65 and Palliative Performance Scale ≤50. Early PC was independently associated with lower DCDAYS (P = .019). Persons admitted to hospice (P = .010) as well as those discharged to home (P = .003) and subacute rehabilitation (SAR; P = .015) were more likely to have an EPC compared to those who died. Admitting to hospice was associated with lower DCDAYS than discharging to long-term acute care (P < .001) or SAR (P < .001). Early PC resulted in lower DCDAYS, fewer inpatient deaths, and higher hospice admissions. Hospice resulted in fewer DCDAYS.

Keywords

palliative care consultation frail elderly patients length of stay discharge destination hospice

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