Physician Use of Advance Care Planning Discussions in a Diverse Hospitalized Population

被引:0
作者
Sonali P. Kulkarni
Leah S. Karliner
Andrew D. Auerbach
Eliseo J. Pérez-Stable
机构
[1] University of California,Robert Wood Johnson Clinical Scholars Program, Department Medicine
[2] University of California,Medical Effectiveness Research Center for Diverse Populations, Division of General Internal Medicine, Department of Medicine
[3] University of California,Division of Hospital Medicine, Department of Medicine
来源
Journal of Immigrant and Minority Health | 2011年 / 13卷
关键词
Care discussion; Diverse populations; Hospital admission; Patient care planning;
D O I
暂无
中图分类号
学科分类号
摘要
Two decades after the Patient Self Determination Act it is unknown how often physicians have advance care planning (ACP) discussions with hospitalized patients. The objective of this study is to investigate use of ACP discussions in a multi-ethnic, multi-lingual hospitalized population. Cross-sectional communication study of hospitalized patients. The Participants are 369 patients at one urban county hospital and one academic medical center. Interventions are not applicable. Participants were asked at baseline and a post-discharge interview whether hospital physicians had discussed either (a) what type of treatment they would want if they could not make decisions for themselves or (b) whether they would want cardiopulmonary resuscitation if needed. We compared patient characteristics for those who did and did not have an ACP discussion. Only 151 (41%) participants reported an ACP discussion. Rates of ACP were low across ethnic, language, education and age groups. In a multivariate model, scoring higher on a co-morbidity scale was associated with higher odds of reporting having had an ACP discussion during hospitalization; this finding remained after adjusting for time period and site of data collection. Multiethnic, multi-lingual hospitalized patients reported low rates of ACP discussions with their physicians regardless of ethnicity, English proficiency, education level or age.
引用
收藏
页码:620 / 624
页数:4
相关论文
共 27 条
[1]  
Kwak J(2005)Current research findings on end-of-life decision making among racially or ethnically diverse groups Gerontologist 45 634-641
[2]  
Haley WE(2009)Racial and ethnic differences in end-of-life costs: why do minorities cost more than whites? Arch Intern Med 169 493-501
[3]  
Hanchate A(2008)Identification of limited English proficiency patients: does the U.S. census question measure up? J Gen Intern Med 23 1555-1560
[4]  
Kronman AC(2003)The self-administered comorbidity questionnaire: a new method to assess comorbidity for clinical and health services research Arthritis Rheum 49 156-163
[5]  
Young-Xu Y(1997)Patient preferences for communication with physicians about end-of-life decisions. SUPPORT Investigators. Study to understand prognoses and preference for outcomes and risks of treatment Ann Intern Med 127 1-12
[6]  
Ash AS(2005)Cardiopulmonary resuscitation is not addressed in the admitting records for the majority of patients who undergo CPR in the hospital Am J Hosp Palliat Care 22 20-25
[7]  
Emanuel E(1995)Advance care planning as a process: structuring discussions in practice J Am Geriatr Soc 43 440-446
[8]  
Karliner LS(2008)Factors associated with discussion of care plans and code status at the time of hospital admission: results from the multicenter hospitalist study J Hosp Med 3 437-445
[9]  
Napoles-Springer A(undefined)undefined undefined undefined undefined-undefined
[10]  
Schillinger D(undefined)undefined undefined undefined undefined-undefined