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Kidney Week

Abstract: TH-OR097

Temporal Trend of the Provision of Palliative Care Encounter in Hospitalized Patients with ESRD: A Nationwide Analysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Wen, Yumeng, Mount Sinai St. Luke's and Mount Sinai West, New York, New York, United States
  • Hernandez Cuchillas, Marcelo Xavier, Mount Sinai St. Luke's and Mount Sinai West, New York, New York, United States
  • Mariuma, David, Mount Sinai St. Luke's and Mount Sinai West, New York, New York, United States
  • Jiang, Changchuan, Mount Sinai St. Luke's and Mount Sinai West, New York, New York, United States
  • Pan, Di, Mount Sinai St. Luke's and Mount Sinai West, New York, New York, United States
Background

End stage renal disease (ESRD) is major cause of worldwide mortality and morbidity. We sought to investigate the temporal trend of the utilization of palliative care (PC) in hospitalized patients with ESRD in United States.

Methods

We conducted a retrospective study using the national inpatient sample to identify patients with ESRD admitted to hospitals from 2006 to 2014. We sought to determine the temporal trend and factors associated with utilizing palliative care in hospital. Multivariate logistic analysis was performed to calculate odds ratios, adjusting for demographics, hospital characteristics, comorbidities and code status. Analysis was performed using Stata 14.0.

Results

A cohort of 6,280,637 patients was identified from 2006 to 2014, of whom 1.65% had a PC consult referral. The incidence of PC contact increased from 0.39% in 2006 to 2.98% in 2014 (aOR 1.11, p<0.01). Patients who received PC contact, compared to who did not, were older (68.79 vs 64.28, p<0.01), had longer hospital stay (8.37 vs. 6.20 days, p<0.01) and were more likely to die in hospital (49.40% vs. 4.04%, p<0.01). Factors associated with more frequent PC referral included more cormobidities, Caucasian race (compared to minorities), teaching hospitals, larger hospitals, hospitals region other than Northeastern area, household income, medicaid or private insurance, and do not resuscitate (DNR) status (shown in Table 1).

Conclusion

The use of palliative care consultation for patients with ESRD who are admitted to hospitals is approximately 1.65%. Race, socioeconomic status, hospital size, region and teaching status all were associated with differential rates of referral. There was a significant increase in palliative care use observed from 2006 to 2014.