Health Care Utilization by Patients Whose Care Is Managed by a Primary Palliative Care Clinic

被引：0
作者：
不详
机构：
[1] Palliative Care Service, Harborview Medical Cente, Seattle, WA 98104, 325 Ninth Ave
[2] Seattle Cancer Care Alliance, WA
[3] Outpatient Palliative Care Service, Harborview Medical Center, Seattle, WA
[4] School of Nursing, University of Washington, Seattle
来源：
JOURNAL OF HOSPICE & PALLIATIVE NURSING | 2013年 / 15卷 / 07期
基金：
美国国家卫生研究院;
关键词：
emergency department; end-of-life care; health care utilization; hospital admissions; palliative care; primary care;
D O I：
10.1097/01.NJH.0000435068.71301.45
中图分类号：
R47 [护理学];
学科分类号：
1011 ;
摘要：
The lack of primary care providers who are skilled in delivering palliative care may be contributing to higher utilization of health care services for people at the end of life. The purpose of this study was to explore the impact of combined primary and palliative care on health care utilization by patients with a life-limiting illness. Patients received care from a consistent provider via a primary palliative care clinic founded and directed by a nurse practitioner at a public hospital. Chart reviews were conducted on a convenience sample of 146 patients cared for by a primary palliative care clinic between July 1, 2010, and June 30, 2011. Health care utilization after enrolling with the clinic was compared with utilization in the 12 months before the date of enrollment. Statistical analyses estimated a 28.6% reduction in emergency visits after enrollment (95% confidence interval, 0.9%-48.5%, P = .0437) and a 20.2% reduction in hospital admissions (95% confidence interval, -0.7% to 36.8%, P = .0576). These findings suggest that combined primary and palliative care can decrease utilization of health care services by individuals with life-limiting conditions.
引用
收藏
页码：380 / 381
页数：2
相关论文
共 23 条
  • [11] Wiese C.H., Vossen-Wellman A., Morgenthal H.C., Et al., Emergency calls and need for emergency care in patients looked after by a palliative care team: Retrospective interview study with bereaved relatives, BMC Palliat Care, 7, (2008)
  • [12] Beynon T., Gomes B., Murtagh F.E., Et al., Howcommon are palliative care needs among older people who die in the emergency department?, Emerg Med J, 28, pp. 491-495, (2011)
  • [13] Owensd Eby K., Burson S., Et al., Primary palliative care clinic pilot project demonstrates benefits of a nurse practitioner-directed clinic providing primary and palliative care, J Am Acad Nurse Pract, 24, 1, pp. 52-58, (2012)
  • [14] Lawson B.J., Burge F.I., McIntyre P., Field S., Maxwell D., Can the introduction of an integrated service model to an existing comprehensive palliative care service impact emergency department visits among enrolled patients?, J Palliat Med, 12, 3, pp. 245-252, (2009)
  • [15] Brumley R., Enguidanos S., Jamison P., Seitz R., Morgenstern N., Saito S., McIlwane J., Hillary K., Gonzalez J., Increased satisfaction with care and lower costs: Results of a randomized trial of in-home palliative care, Journal of the American Geriatrics Society, 55, 7, pp. 993-1000, (2007)
  • [16] Comart J., Mahler A., Schreiber R., Et al., Palliative Care for Longterm Care Residents: Effect on Clinical Outcomes, 7, (2012)
  • [17] Aiken L.S., Butner J., Lockhart C.A., Volk-Craft B.E., Hamilton G., Williams F.G., Outcome evaluation of a randomized trial of the PhoenixCare intervention: Program of case management and coordinated care for the seriously chronically ill, Journal of Palliative Medicine, 9, 1, pp. 111-126, (2006)
  • [18] Follwell M., Burman Le D L.W., Et al., Phase II study of an outpatient palliative care intervention in patients with metastatic cancer, J Clin Oncol, 27, 2, pp. 206-213, (2009)
  • [19] Rabow M.W., Dibble S.L., Pantilat S.Z., McPhee S.J., The comprehensive care team: A controlled trial of outpatient palliative medicine consultation, Archives of Internal Medicine, 164, 1, pp. 83-91, (2004)
  • [20] Zimmermann C., Riechelmann R., Krzyzanowska M., Rodin G., Tannock I., Effectiveness of specialized palliative care: A systematic review, JAMA - Journal of the American Medical Association, 299, 14, pp. 1698-1709, (2008)
123