TY - JOUR
T1 - Use of palliative care services in a tertiary cancer center
AU - Dalal, Shalini
AU - Bruera, Sebastian
AU - Hui, David
AU - Yennu, Sriram
AU - Dev, Rony
AU - Williams, Janet
AU - Masoni, Charles
AU - Ihenacho, Ijeoma
AU - Obasi, Emmanuel
AU - Bruera, Eduardo
N1 - Publisher Copyright:
© AlphaMed Press 2016.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background. Despite increasing prevalence of palliative care (PC) services in cancer centers, most referrals to the service occur exceedingly late in the illness trajectory. Over the years, we have made several attempts to promote earlier patient access to our PC program, such as changing the name of our service from PC to supportive care (SC). This study was conducted to determine the use of PC/SC service over the past 8 years. Methods. We reviewed billing data for all PC/SC encounters. We examined five metrics for use: inpatient consultations as a percentage of hospital admissions, ratio of inpatient consultations to average number of operational beds, time from hospital registration to outpatient consultation, time from advanced cancer diagnosis to consultation, and time from first outpatient consultation to death/last follow-up. Results. Over the years, we found a consistent increase in patient referrals to the PC/SC program. In the inpatient setting, we found approximate doubling of the inpatient consultations as a percentage of hospital admissions and the ratio of inpatient consultations to hospital beds (from 10% to 19% and from 2.4 to 4.9, respectively; p < .001). In the outpatient setting, we observed variations in referral pattern between oncology services, but, overall, the time from consultation to death/last follow-up increased from 4.8 months to 7.9 months (p = .001), which was accompanied by a significant decrease in the interval to consultation from hospital registration and advanced cancer diagnosis (p < .001). Conclusion. We have observed a consistent annual increase in new patient referrals as well as earlier access for outpatient referrals to our SC service, supporting increased use of palliative care at our cancer center.
AB - Background. Despite increasing prevalence of palliative care (PC) services in cancer centers, most referrals to the service occur exceedingly late in the illness trajectory. Over the years, we have made several attempts to promote earlier patient access to our PC program, such as changing the name of our service from PC to supportive care (SC). This study was conducted to determine the use of PC/SC service over the past 8 years. Methods. We reviewed billing data for all PC/SC encounters. We examined five metrics for use: inpatient consultations as a percentage of hospital admissions, ratio of inpatient consultations to average number of operational beds, time from hospital registration to outpatient consultation, time from advanced cancer diagnosis to consultation, and time from first outpatient consultation to death/last follow-up. Results. Over the years, we found a consistent increase in patient referrals to the PC/SC program. In the inpatient setting, we found approximate doubling of the inpatient consultations as a percentage of hospital admissions and the ratio of inpatient consultations to hospital beds (from 10% to 19% and from 2.4 to 4.9, respectively; p < .001). In the outpatient setting, we observed variations in referral pattern between oncology services, but, overall, the time from consultation to death/last follow-up increased from 4.8 months to 7.9 months (p = .001), which was accompanied by a significant decrease in the interval to consultation from hospital registration and advanced cancer diagnosis (p < .001). Conclusion. We have observed a consistent annual increase in new patient referrals as well as earlier access for outpatient referrals to our SC service, supporting increased use of palliative care at our cancer center.
KW - Cancer
KW - End-of-life care
KW - Palliative care
KW - Supportive care
UR - http://www.scopus.com/inward/record.url?scp=84954314637&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84954314637&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.2015-0234
DO - 10.1634/theoncologist.2015-0234
M3 - Article
C2 - 26614711
AN - SCOPUS:84954314637
SN - 1083-7159
VL - 21
SP - 110
EP - 118
JO - Oncologist
JF - Oncologist
IS - 1
ER -