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Allaudeen N, Millhouse CF, Huberman DB, Wang H, Heidenreich PA. Late to Palliate? Inpatient Palliative Care Consultation at an Academic Veterans Affairs Hospital. Military medicine. 2023 Nov 3; 188(11-12):e3363-e3367.
INTRODUCTION: Despite robust evidence describing the benefits of palliative care consultation (PCC), this service is underutilized. Hospital admission provides an important opportunity to obtain PCC. METHODS: We evaluated all inpatients who received PCC at a Veterans Affairs academic hospital from January 1, 2019 to December 31, 2019. Logistic regression was used to determine factors associated with early versus late PCC, with early defined as > 30?days from consult to death and late defined as = 30?days. RESULTS: The median time from PCC to death was 37?days. The majority of PCCs were early (58.4%). Of all patients receiving inpatient PCC, 13.2% died that admission. Cardiac (odds ratio? = 0.3, 95% CI? = 0.11-0.73) and neurological (odds ratio? = 0.21, 95% CI? = 0.05-0.70) diagnoses were more likely to receive early PCC compared to malignancy. Of the late PCCs receiving first-time consults, 58.9% had at least one admission during the last year. CONCLUSIONS: Many patients are introduced to palliative care services within a month of death. These patients were often admitted during the prior year, presenting a missed opportunity to involve inpatient PCC earlier.