Trends of Hospital Palliative Care Utilization and Its Associated Factors Among Patients With Systemic Lupus Erythematosus in the United States From 2005 to 2014

Author:

Yu Kaylee G.1,Shen Jay J.2,Kim Pearl C.2,Kim Sun Jung3,Lee Se Won4,Byun David5,Yoo Ji Won6ORCID,Hwang Jinwook7ORCID

Affiliation:

1. Department of Internal Medicine, Mountain View Hospital, Las Vegas, NV, USA

2. Department of Health Care Administration and Policy School of Community Health Sciences, University of Nevada Las Vegas, NV, USA

3. Department of Health Administration and Management, Soonchunhyang University, Asan, Chungcheongnam-do, South Korea

4. Department of Physical Medicine and Rehabilitation, Mountain View Hospital, Las Vegas, NV, USA

5. Department of Internal Medicine, Southern Nevada Veterans Affairs Health System, North Las Vegas, NV, USA

6. Department of Internal Medicine, University of Nevada Las Vegas, School of Medicine, NV, USA

7. Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Ansan Hospital, Korea University College of Medicine, Ansan, South Korea

Abstract

Objective: To investigate trends and associated factors of utilization of hospital palliative care among patients with systemic lupus erythematosus (SLE) and analyze its impact on length of hospital stay, hospital charges, and in-hospital mortality. Methods: Using the 2005-2014 National Inpatient Sample in the United States, the compound annual growth rate was used to investigate the temporal trend of utilization of hospital palliative care. Multivariate multilevel logistic regression analyses were performed to analyze the association with patient-related factors, hospital factors, length of stay, in-hospital mortality, and hospital charges. Results: The overall proportion of utilization of hospital palliative care for the patient with SLE was 0.6% over 10 years. It increased approximately 12-fold from 0.1% (2005) to 1.17% (2014). Hospital palliative care services were offered more frequently to older patients, patients with high severity illnesses, and in urban teaching hospitals or large size hospitals. Patients younger than 40 years, the lowest household income group, or Medicare beneficiaries less likely received palliative care during hospitalization. Hospital palliative care services were associated with increased length of stay (β = 1.407, P < .0001) and in-hospital mortality (odds ratio, 48.18; 95% confidence interval, 41.59-55.82), and reduced hospital charge (β = −0.075, P = .009). Conclusion: Hospital palliative care service for patients with SLE gradually increased during the past decade in US hospitals. However, this showed disparities in access and was associated with longer hospital length of stay and higher in-hospital mortality. Nevertheless, hospital palliative care services yielded a cost-saving effect.

Publisher

SAGE Publications

Subject

General Medicine

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