Comparison of Early Versus Late Palliative Care Consultation in End-of-Life Care for the Hospitalized Frail Elderly Patients

Abstract

To examine the effects of early palliative care (PC; EPC; ≤3 days after admission) consultation versus late PC (>3 days) on number of days from day of consult to discharge (DCDAYS), a retrospective review of PC data (2009-2012) included 531 patients with age ≥65 and Palliative Performance Scale ≤50. Early PC was independently associated with lower DCDAYS (P = .019). Persons admitted to hospice (P = .010) as well as those discharged to home (P = .003) and subacute rehabilitation (SAR; P = .015) were more likely to have an EPC compared to those who died. Admitting to hospice was associated with lower DCDAYS than discharging to long-term acute care (P < .001) or SAR (P < .001). Early PC resulted in lower DCDAYS, fewer inpatient deaths, and higher hospice admissions. Hospice resulted in fewer DCDAYS.

Keywords: consultation; discharge destination; frail elderly patients; hospice; length of stay; palliative care.