Access to Palliative Care Consultation for Hospitalized Adults with COVID-19 in an Urban Health System: Were There Disparities at the Peak of the Pandemic?

Julia L. Frydman, Melissa Aldridge, Jaison Moreno, Joshua Singer, Li Zeng, Emily Chai, R. Sean Morrison, Laura P. Gelfman

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: Palliative care (PC) services expanded rapidly to meet the needs of coronavirus disease 2019 (COVID-19) patients, yet little is known about which patients were referred for PC consultation during the pandemic. Objective: Examine factors predictive of PC consultation for COVID-19 patients. Design: Retrospective cohort study of COVID-19 patients discharged from four hospitals (March 1-June 30, 2020). Exposures: Patient demographic, socioeconomic, and clinical factors and hospital-level characteristics. Outcome Measurement: Inpatient PC consultation. Results: Of 4319 hospitalized COVID-19 patients, 581 (14%) received PC consultation. Increasing age, serious illness (cancer, chronic obstructive pulmonary disease, and dementia), greater illness severity, and admission to the quaternary hospital were associated with receipt of PC consultation. There was no association between PC consultation and race/ethnicity, household crowding, insurance status, or hospital-factors, including inpatient, emergency department, and intensive care unit census. Conclusions: Although site variation existed, the highest acuity patients were most likely to receive PC consultation without racial/ethnic or socioeconomic disparities.

Original languageEnglish
Pages (from-to)124-129
Number of pages6
JournalJournal of Palliative Medicine
Volume25
Issue number1
DOIs
StatePublished - 1 Jan 2022

Keywords

  • disparities in palliative care
  • hospitalized patients with COVID-19
  • inpatient palliative care consultation
  • pandemic palliative care

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