Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States
<b>Background:</b> This study aimed to determine the rates of inpatient palliative care service use and assess the impact of palliative care service use on in-hospital treatments and resource utilization in hospital admissions for hepatorenal syndrome. <b>Methods:</b> Using t...
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doaj-c46eac273ad94018a9c73fd7c098c8322021-05-31T23:45:38ZengMDPI AGMedicines2305-63202021-05-018212110.3390/medicines8050021Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United StatesCharat Thongprayoon0Wisit Kaewput1Tananchai Petnak2Oisin A. O’Corragain3Boonphiphop Boonpheng4Tarun Bathini5Saraschandra Vallabhajosyula6Pattharawin Pattharanitima7Ploypin Lertjitbanjong8Fawad Qureshi9Wisit Cheungpasitporn10Department of Medicine, Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN 55905, USADepartment of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok 10400, ThailandDivision of Pulmonary and Pulmonary Critical Care Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA 19140, USADepartment of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USADepartment of Internal Medicine, University of Arizona, Tucson, AZ 85719, USASection of Interventional Cardiology, Department of Medicine, Division of Cardiovascular Medicine, Emory University School of Medicine, Atlanta, GA 30322, USADepartment of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 12120, ThailandDivision of Pulmonary, Critical Care and Sleep Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USADepartment of Medicine, Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN 55905, USADepartment of Medicine, Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN 55905, USA<b>Background:</b> This study aimed to determine the rates of inpatient palliative care service use and assess the impact of palliative care service use on in-hospital treatments and resource utilization in hospital admissions for hepatorenal syndrome. <b>Methods:</b> Using the National Inpatient Sample, hospital admissions with a primary diagnosis of hepatorenal syndrome were identified from 2003 through 2014. The primary outcome of interest was the temporal trend and predictors of inpatient palliative care service use. Logistic and linear regression was performed to assess the impact of inpatient palliative care service on in-hospital treatments and resource use. <b>Results:</b> Of 5571 hospital admissions for hepatorenal syndrome, palliative care services were used in 748 (13.4%) admissions. There was an increasing trend in the rate of palliative care service use, from 3.3% in 2003 to 21.1% in 2014 (<i>p</i> < 0.001). Older age, more recent year of hospitalization, acute liver failure, alcoholic cirrhosis, and hepatocellular carcinoma were predictive of increased palliative care service use, whereas race other than Caucasian, African American, and Hispanic and chronic kidney disease were predictive of decreased palliative care service use. Although hospital admission with palliative care service use had higher mortality, palliative care service was associated with lower use of invasive mechanical ventilation, blood product transfusion, paracentesis, renal replacement, vasopressor but higher DNR status. Palliative care services reduced mean length of hospital stay and hospitalization cost. <b>Conclusion:</b> Although there was a substantial increase in the use of palliative care service in hospitalizations for hepatorenal syndrome, inpatient palliative care service was still underutilized. The use of palliative care service was associated with reduced resource use.https://www.mdpi.com/2305-6320/8/5/21hepatorenal syndromepalliative careresource utilizationoutcomeshospitalization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Charat Thongprayoon Wisit Kaewput Tananchai Petnak Oisin A. O’Corragain Boonphiphop Boonpheng Tarun Bathini Saraschandra Vallabhajosyula Pattharawin Pattharanitima Ploypin Lertjitbanjong Fawad Qureshi Wisit Cheungpasitporn |
spellingShingle |
Charat Thongprayoon Wisit Kaewput Tananchai Petnak Oisin A. O’Corragain Boonphiphop Boonpheng Tarun Bathini Saraschandra Vallabhajosyula Pattharawin Pattharanitima Ploypin Lertjitbanjong Fawad Qureshi Wisit Cheungpasitporn Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States Medicines hepatorenal syndrome palliative care resource utilization outcomes hospitalization |
author_facet |
Charat Thongprayoon Wisit Kaewput Tananchai Petnak Oisin A. O’Corragain Boonphiphop Boonpheng Tarun Bathini Saraschandra Vallabhajosyula Pattharawin Pattharanitima Ploypin Lertjitbanjong Fawad Qureshi Wisit Cheungpasitporn |
author_sort |
Charat Thongprayoon |
title |
Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States |
title_short |
Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States |
title_full |
Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States |
title_fullStr |
Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States |
title_full_unstemmed |
Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States |
title_sort |
impact of palliative care services on treatment and resource utilization for hepatorenal syndrome in the united states |
publisher |
MDPI AG |
series |
Medicines |
issn |
2305-6320 |
publishDate |
2021-05-01 |
description |
<b>Background:</b> This study aimed to determine the rates of inpatient palliative care service use and assess the impact of palliative care service use on in-hospital treatments and resource utilization in hospital admissions for hepatorenal syndrome. <b>Methods:</b> Using the National Inpatient Sample, hospital admissions with a primary diagnosis of hepatorenal syndrome were identified from 2003 through 2014. The primary outcome of interest was the temporal trend and predictors of inpatient palliative care service use. Logistic and linear regression was performed to assess the impact of inpatient palliative care service on in-hospital treatments and resource use. <b>Results:</b> Of 5571 hospital admissions for hepatorenal syndrome, palliative care services were used in 748 (13.4%) admissions. There was an increasing trend in the rate of palliative care service use, from 3.3% in 2003 to 21.1% in 2014 (<i>p</i> < 0.001). Older age, more recent year of hospitalization, acute liver failure, alcoholic cirrhosis, and hepatocellular carcinoma were predictive of increased palliative care service use, whereas race other than Caucasian, African American, and Hispanic and chronic kidney disease were predictive of decreased palliative care service use. Although hospital admission with palliative care service use had higher mortality, palliative care service was associated with lower use of invasive mechanical ventilation, blood product transfusion, paracentesis, renal replacement, vasopressor but higher DNR status. Palliative care services reduced mean length of hospital stay and hospitalization cost. <b>Conclusion:</b> Although there was a substantial increase in the use of palliative care service in hospitalizations for hepatorenal syndrome, inpatient palliative care service was still underutilized. The use of palliative care service was associated with reduced resource use. |
topic |
hepatorenal syndrome palliative care resource utilization outcomes hospitalization |
url |
https://www.mdpi.com/2305-6320/8/5/21 |
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