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Factors Associated With Hospital Admission in the Last Month: A Retrospective Single Center Analysis.

Publication ,  Journal Article
Ma, JE; Olsen, MK; McDermott, CL; Bowling, CB; Hastings, SN; White, T; Casarett, D
Published in: J Pain Symptom Manage
June 2024

CONTEXT: Driven by concerns about care quality, patient experience, and national metrics, health systems are increasingly focusing on identifying risk factors for patients who are hospitalized in the last month of life. OBJECTIVE: To evaluate patient factors associated with hospital admission in the last month (30 days). METHODS: We analyzed a retrospective cohort of 8488 patients with a primary care visit in a tertiary health system in the last year of life using a linked electronic health record and decedent dataset. We examined healthcare utilization (primary care, emergency, hospital, intensive care unit encounters) and end-of-life related outcomes (palliative care consultation, do-not-resuscitate orders, advance care planning documentation, hospice at hospital discharge, death in health system). Multivariable logistic regressions identified patient factors associated with admission in the last month. RESULTS: About 2202 (25.9%) patients had a hospital admission in the last month. Among the 1282 (15.1%) who died in a health system facility, most (1103/1282, 86.0%) were admitted to the hospital in the last month. Among patients with a hospital admission and discharged in the last month, 60.9% (686/1126) were discharged on hospice. Compared to those without these diseases, metastatic cancer, liver disease, or heart failure had the highest odds of admission in the last month (adjusted OR 2.36 95%CI 2.05-2.72; 2.28, 95%CI 1.98-2.62; and 2.17 95%CI 1.93-2.45 respectively). CONCLUSIONS: As patients with heart or liver disease or metastatic cancer had the highest odds of admission in the last month, collaborative interventions between primary, palliative, and specialty care may improve quality of care at the end of life.

Duke Scholars

Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

June 2024

Volume

67

Issue

6

Start / End Page

535 / 543

Location

United States

Related Subject Headings

  • Terminal Care
  • Risk Factors
  • Retrospective Studies
  • Resuscitation Orders
  • Primary Health Care
  • Patient Discharge
  • Palliative Care
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ma, J. E., Olsen, M. K., McDermott, C. L., Bowling, C. B., Hastings, S. N., White, T., & Casarett, D. (2024). Factors Associated With Hospital Admission in the Last Month: A Retrospective Single Center Analysis. J Pain Symptom Manage, 67(6), 535–543. https://doi.org/10.1016/j.jpainsymman.2024.03.003
Ma, Jessica E., Maren K. Olsen, Cara L. McDermott, C Barrett Bowling, S Nicole Hastings, Tyler White, and David Casarett. “Factors Associated With Hospital Admission in the Last Month: A Retrospective Single Center Analysis.J Pain Symptom Manage 67, no. 6 (June 2024): 535–43. https://doi.org/10.1016/j.jpainsymman.2024.03.003.
Ma JE, Olsen MK, McDermott CL, Bowling CB, Hastings SN, White T, et al. Factors Associated With Hospital Admission in the Last Month: A Retrospective Single Center Analysis. J Pain Symptom Manage. 2024 Jun;67(6):535–43.
Ma, Jessica E., et al. “Factors Associated With Hospital Admission in the Last Month: A Retrospective Single Center Analysis.J Pain Symptom Manage, vol. 67, no. 6, June 2024, pp. 535–43. Pubmed, doi:10.1016/j.jpainsymman.2024.03.003.
Ma JE, Olsen MK, McDermott CL, Bowling CB, Hastings SN, White T, Casarett D. Factors Associated With Hospital Admission in the Last Month: A Retrospective Single Center Analysis. J Pain Symptom Manage. 2024 Jun;67(6):535–543.
Journal cover image

Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

June 2024

Volume

67

Issue

6

Start / End Page

535 / 543

Location

United States

Related Subject Headings

  • Terminal Care
  • Risk Factors
  • Retrospective Studies
  • Resuscitation Orders
  • Primary Health Care
  • Patient Discharge
  • Palliative Care
  • Middle Aged
  • Male
  • Humans