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Association between referral-to-death interval and location of death of patients referred to a hospital-based specialist palliative care service.
J Pain Symptom Manage. 2013 Aug; 46(2):173-81.JP

Abstract

CONTEXT

The time interval between palliative care referral and death may play a role in determining the last place of care and location of death of patients referred to palliative care teams.

OBJECTIVES

To examine the association between the referral-to-death interval and location of death of patients referred to a hospital-based palliative care service in Singapore.

METHODS

A retrospective analysis of data from a palliative care service's administrative database was performed. Individual patient's referral-to-death interval was calculated using the date of first contact with the service and date of death. Multinomial regression analysis was done to determine the influence of referral-to-death interval in predicting death at home and in an inpatient hospice facility compared with death in hospital, separately by gender.

RESULTS

Of 842 patients, 52% were female and 56% were aged 65 years or older. Terminal cancer was the diagnosis for most patients (86%). Three hundred ninety patients (46%) died outside the hospital setting. A referral-to-death interval of ≥30 days (as opposed to <30 days) was associated with an increased likelihood of dying at home (odds ratio [OR] 2.21, 95% CI 1.34-3.67 for males and OR 3.33, 95% CI 2.07-5.35 for females) or in an inpatient hospice facility (OR 2.02, 95% CI 1.13-3.60 for males and OR 2.69, 95% CI 1.55-4.66 for females) compared with death in hospital. Male patients' age, ethnicity, and marital status were found to be the contributing factors in predicting death at home.

CONCLUSION

Longer referral-to-death interval was associated with death outside the hospital for patients enrolled in a hospital-based service. The study highlights the importance of early referral in predicting the last place of care and location of death of palliative care patients.

Authors+Show Affiliations

Lien Centre for Palliative Care, Duke-NUS Graduate Medical School Singapore, Singapore.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23177723

Citation

Poulose, Jissy Vijo, et al. "Association Between Referral-to-death Interval and Location of Death of Patients Referred to a Hospital-based Specialist Palliative Care Service." Journal of Pain and Symptom Management, vol. 46, no. 2, 2013, pp. 173-81.
Poulose JV, Do YK, Neo PS. Association between referral-to-death interval and location of death of patients referred to a hospital-based specialist palliative care service. J Pain Symptom Manage. 2013;46(2):173-81.
Poulose, J. V., Do, Y. K., & Neo, P. S. (2013). Association between referral-to-death interval and location of death of patients referred to a hospital-based specialist palliative care service. Journal of Pain and Symptom Management, 46(2), 173-81. https://doi.org/10.1016/j.jpainsymman.2012.08.009
Poulose JV, Do YK, Neo PS. Association Between Referral-to-death Interval and Location of Death of Patients Referred to a Hospital-based Specialist Palliative Care Service. J Pain Symptom Manage. 2013;46(2):173-81. PubMed PMID: 23177723.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between referral-to-death interval and location of death of patients referred to a hospital-based specialist palliative care service. AU - Poulose,Jissy Vijo, AU - Do,Young Kyung, AU - Neo,Patricia Soek Hui, Y1 - 2012/11/21/ PY - 2012/03/27/received PY - 2012/08/06/revised PY - 2012/08/06/accepted PY - 2012/11/27/entrez PY - 2012/11/28/pubmed PY - 2014/2/25/medline KW - Palliative care KW - Singapore KW - hospital KW - place of death KW - timing of referral SP - 173 EP - 81 JF - Journal of pain and symptom management JO - J Pain Symptom Manage VL - 46 IS - 2 N2 - CONTEXT: The time interval between palliative care referral and death may play a role in determining the last place of care and location of death of patients referred to palliative care teams. OBJECTIVES: To examine the association between the referral-to-death interval and location of death of patients referred to a hospital-based palliative care service in Singapore. METHODS: A retrospective analysis of data from a palliative care service's administrative database was performed. Individual patient's referral-to-death interval was calculated using the date of first contact with the service and date of death. Multinomial regression analysis was done to determine the influence of referral-to-death interval in predicting death at home and in an inpatient hospice facility compared with death in hospital, separately by gender. RESULTS: Of 842 patients, 52% were female and 56% were aged 65 years or older. Terminal cancer was the diagnosis for most patients (86%). Three hundred ninety patients (46%) died outside the hospital setting. A referral-to-death interval of ≥30 days (as opposed to <30 days) was associated with an increased likelihood of dying at home (odds ratio [OR] 2.21, 95% CI 1.34-3.67 for males and OR 3.33, 95% CI 2.07-5.35 for females) or in an inpatient hospice facility (OR 2.02, 95% CI 1.13-3.60 for males and OR 2.69, 95% CI 1.55-4.66 for females) compared with death in hospital. Male patients' age, ethnicity, and marital status were found to be the contributing factors in predicting death at home. CONCLUSION: Longer referral-to-death interval was associated with death outside the hospital for patients enrolled in a hospital-based service. The study highlights the importance of early referral in predicting the last place of care and location of death of palliative care patients. SN - 1873-6513 UR - https://www.unboundmedicine.com/medline/citation/23177723/Association_between_referral_to_death_interval_and_location_of_death_of_patients_referred_to_a_hospital_based_specialist_palliative_care_service_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0885-3924(12)00469-1 DB - PRIME DP - Unbound Medicine ER -