scholarly journals Impact of applying palliative care on symptoms and survival of patients with advanced chronic disease admitted to the emergency department

2020 ◽  
Vol 26 (3) ◽  
pp. 332
Author(s):  
JoseP Amado ◽  
Rolando Vasquez ◽  
Roberto Huari ◽  
Liliana Rimache ◽  
Rosa Lizonde
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Chronic Disease ◽  
Advanced Chronic Disease

scholarly journals Variations in the cost of formal and informal health care for patients with advanced chronic disease and refractory breathlessness: A cross-sectional secondary analysis

2017 ◽  
Vol 31 (4) ◽  
pp. 369-377 ◽  
Author(s):  
Mendwas D Dzingina ◽  
Charles C Reilly ◽  
Claudia Bausewein ◽  
Caroline J Jolley ◽  
John Moxham ◽  
...  
Keyword(s):  
Palliative Care ◽  
Chronic Disease ◽  
Standard Deviation ◽  
Advanced Disease ◽  
Secondary Analysis ◽  
Formal Care ◽  
Cross Sectional ◽  
Informal Carers ◽  
The Cost ◽  
Advanced Chronic Disease

Background: Refractory breathlessness in advanced chronic disease leads to high levels of disability, anxiety and social isolation. These result in high health-resource use, although this is not quantified. Aims: To measure the cost of care for patients with advanced disease and refractory breathlessness and to identify factors associated with high costs. Design: A cross-sectional secondary analysis of data from a randomised controlled trial. Setting/participants: Patients with advanced chronic disease and refractory breathlessness recruited from three National Health Service hospitals and via general practitioners in South London. Results: Of 105 patients recruited, the mean cost of formal care was £3253 (standard deviation £3652) for 3 months. The largest contributions to formal-care cost were hospital admissions (>60%), and palliative care contributed <1%. When informal care was included, the total cost increased by >250% to £11,507 (standard deviation £9911). Increased patient disability resulting from breathlessness was associated with high cost (£629 per unit increase in disability score; p = 0.006). Increased breathlessness on exertion and the presence of an informal carer were also significantly associated with high cost. Patients with chronic obstructive pulmonary disease tended to have higher healthcare costs than other patients. Conclusion: Informal carers contribute significantly to the care of patients with advanced disease and refractory breathlessness. Disability resulting from breathlessness is an important clinical cost driver. It is important for policy makers to support and acknowledge the contributions of informal carers. Further research is required to assess the clinical- and cost-effectiveness of palliative care interventions in reducing disability resulting from breathlessness in this patient group.

Harnessing the Chaplain’s Capacity to Identify Unmet Palliative Needs of Vulnerable Older Adults in the Emergency Department

2021 ◽  
pp. 082585972110033
Author(s):  
Elizabeth Hamill Howard ◽  
Rachel Schwartz ◽  
Bruce Feldstein ◽  
Marita Grudzen ◽  
Lori Klein ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
End Of Life Care ◽  
Older Patients ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Life Care ◽  
Emergency Medicine Physician ◽  
Medicine Physician ◽  
One Year

Objective: To explore chaplains’ ability to identify unmet palliative care (PC) needs in older emergency department (ED) patients. Methods: A palliative chaplain-fellow conducted a retrospective chart review evaluating 580 ED patients, age ≥80 using the Palliative Care and Rapid Emergency Screening (P-CaRES) tool. An emergency medicine physician and chaplain-fellow screened 10% of these charts to provide a clinical assessment. One year post-study, charts were re-examined to identify which patients received PC consultation (PCC) or died, providing an objective metric for comparing predicted needs with services received. Results: Within one year of ED presentation, 31% of the patient sub-sample received PCC; 17% died. Forty percent of deceased patients did not receive PCC. Of this 40%, chaplain screening for P-CaRES eligibility correctly identified 75% of the deceased as needing PCC. Conclusion: Establishing chaplain-led PC screenings as standard practice in the ED setting may improve end-of-life care for older patients.

scholarly journals Hospital-based acute care in the last 30 days of life among patients with chronic disease that received early, late or no specialist palliative care: a retrospective cohort study of eight chronic disease groups

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044196
Author(s):  
Madalene Earp ◽  
Pin Cai ◽  
Andrew Fong ◽  
Kelly Blacklaws ◽  
Truong-Minh Pham ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cohort Study ◽  
Heart Disease ◽  
Chronic Disease ◽  
Acute Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hospital Admissions ◽  
Specialist Palliative Care ◽  
Icu Admission

ObjectiveFor eight chronic diseases, evaluate the association of specialist palliative care (PC) exposure and timing with hospital-based acute care in the last 30 days of life.DesignRetrospective cohort study using administrative data.SettingAlberta, Canada between 2007 and 2016.Participants47 169 adults deceased from: (1) cancer, (2) heart disease, (3) dementia, (4) stroke, (5) chronic lower respiratory disease (chronic obstructive pulmonary disease (COPD)), (6) liver disease, (7) neurodegenerative disease and (8) renovascular disease.Main outcome measuresThe proportion of decedents who experienced high hospital-based acute care in the last 30 days of life, indicated by ≥two emergency department (ED) visit, ≥two hospital admissions,≥14 days of hospitalisation, any intensive care unit (ICU) admission, or death in hospital. Relative risk (RR) and risk difference (RD) of hospital-based acute care given early specialist PC exposure (≥90 days before death), adjusted for patient characteristics.ResultsIn an analysis of all decedents, early specialist PC exposure was associated with a 32% reduction in risk of any hospital-based acute care as compared with those with no PC exposure (RR 0.69, 95% CI 0.66 to 0.71; RD 0.16, 95% CI 0.15 to 0.17). The association was strongest in cancer-specific analyses (RR 0.53, 95% CI 0.50 to 0.55; RD 0.31, 95% CI 0.29 to 0.33) and renal disease-specific analyses (RR 0.60, 95% CI 0.43 to 0.84; RD 0.22, 95% CI 0.11 to 0.34), but a~25% risk reduction was observed for each of heart disease, COPD, neurodegenerative diseases and stroke. Early specialist PC exposure was associated with reducing risk of four out of five individual indicators of high hospital-based acute care in the last 30 days of life, including ≥two ED visit,≥two hospital admission, any ICU admission and death in hospital.ConclusionsEarly specialist PC exposure reduced the risk of hospital-based acute care in the last 30 days of life for all chronic disease groups except dementia.

scholarly journals Associations between self-harm and chronic disease among adolescents: Cohort study using statewide emergency department data

2019 ◽  
Vol 72 ◽  
pp. 132-140 ◽  
Author(s):  
Cristina Lidón-Moyano ◽  
Deborah Wiebe ◽  
Paul Gruenewald ◽  
Magdalena Cerdá ◽  
Paul Brown ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Chronic Disease ◽  
Emergency Department Data ◽  
Self Harm

scholarly journals Palliative Care Needs of Advanced Cancer Patients in the Emergency Department (S767)

2018 ◽  
Vol 55 (2) ◽  
pp. 693
Author(s):  
Isabelle Marcelin ◽  
Caroline McNaughton ◽  
Nicole Tang ◽  
Jeffrey Caterino ◽  
Corita Grudzen
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Advanced Cancer Patients ◽  
Care Needs ◽  
Palliative Care Needs

Am I Doing the Right Thing? Provider Perspectives on Improving Palliative Care in the Emergency Department

2009 ◽  
Vol 54 (1) ◽  
pp. 86-93.e1 ◽  
Author(s):  
Alexander K. Smith ◽  
Jonathan Fisher ◽  
Mara A. Schonberg ◽  
Daniel J. Pallin ◽  
Susan D. Block ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Provider Perspectives ◽  
The Right

Hospital Administrators' Views on Barriers and Opportunities to Delivering Palliative Care in the Emergency Department

2013 ◽  
Vol 61 (6) ◽  
pp. 654-660 ◽  
Author(s):  
Corita R. Grudzen ◽  
Lynne D. Richardson ◽  
Hannah Major-Monfried ◽  
Brandon Kandarian ◽  
Joanna M. Ortiz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Hospital Administrators ◽  
Barriers And Opportunities
Sign in / Sign up

Export Citation Format

Share Document