Unplanned hospitalizations for metastatic cancers:The changing patterns of inpatient palliative care,discharge to hospice care,and in-hospital mortality in the United States

作     者：Jason L.Salemi Charles C.Chima Kiara K.Spooner Roger J.Zoorob 

作者机构：Department of Family and Community MedicineBaylor College of MedicineHoustonTXUSA 

出 版 物：《Family Medicine and Community Health》 (家庭医学与社区卫生（英文）)

年 卷 期：2017年第5卷第1期

页      面：13-28页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：End-of-life hospice care inpatient mortality metastatic cancer palliative care unplanned hospitalization 

摘      要：Objective:To describe the rates and temporal trends of inpatient end-of-life care among patients hospitalized with metastatic cancer in the United ***:We used data from the Nationwide Inpatient Sample to conduct a cross-sectional analysis of unplanned inpatient hospitalizations of patients aged 18 years or older with metastatic cancer from 2002 to *** logistic regression was used to assess patient-and hospital-level predictors of discharge to hospice care,palliative care,and in-hospital *** trends in outcomes were characterized with use of joinpoint ***:There were an estimated 350,241 unplanned hospitalizations per year of patients with a diagnosis of metastatic *** their inpatient stay,5.8%of patients received palliative care,and among those discharged alive,12.2%were referred to hospice *** rate of inpatient palliative care increased from 2.3%to 13.6%,the rate of discharge to hospice care increased from 4.1%to 15.6%,and the in-hospital mortality rate decreased from more than 14.0%to 9.8%.These patterns were consistent across cancer subtypes,and were most pronounced among patients with extreme risk of ***:Despite increases in the provision of comfort-oriented care to patients with meta-static cancer,few receive such *** recommend screening protocols in hospitals to identify patients who are good candidates for palliative care consultation and hospice referral.