TY - JOUR
T1 - Inpatient palliative care use by patients with sickle cell disease
T2 - A retrospective cross-sectional study
AU - Nwogu-Onyemkpa, Eberechi
AU - Dongarwar, Deepa
AU - Salihu, Hamisu M.
AU - Akpati, Lois
AU - Marroquin, Maricarmen
AU - Abadom, Megan
AU - Naik, Aanand D.
N1 - Publisher Copyright:
© BMJ Publishing Group Limited 2022.
PY - 2022/8/16
Y1 - 2022/8/16
N2 - Objective Sickle cell disease (SCD) is a highly morbid condition notable for recurrent hospitalisations due to vaso-occlusive crises and complications of end organ damage. Little is known about the use of inpatient palliative care services in adult patients with SCD. This study aims to evaluate inpatient palliative care use during SCD-related hospitalisations overall and during terminal hospitalisations. We hypothesise that use of palliative care is low in SCD hospitalisations. Design A retrospective cross-sectional study using data from the National Inpatient Sample from 2008 to 2017 was conducted. Setting US hospitals from 47 states and the District of Columbia. Participants Patients >18 years old hospitalised with a primary or secondary International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or ICD-10-CM diagnosis of SCD were included. Primary and secondary outcome measures Palliative care service use (documented by ICD-9-CM and ICD-10-CM diagnosis codes V66.7 and Z51.5). Results 987 555 SCD-related hospitalisations were identified, of which 4442 (0.45%) received palliative care service. Palliative care service use increased at a rate of 9.2% per year (95% CI 5.6 to 12.9). NH-black and Hispanic patients were 33% and 53% less likely to have palliative care services compared with NH-white patients (OR 0.67; 95% CI 0.45 to 0.99 and OR 0.47; 95% CI 0.26 to 0.84). Female patients (OR 0.40; 95% CI 0.21 to 0.76), Medicaid use (OR 0.40; 95% CI 0.21 to 0.78), rural (OR 0.47; 95% CI 0.28 to 0.79) and urban non-teaching hospitals (OR 0.61; 95% CI 0.47 to 0.80) each had a lower likelihood of palliative care services use. Conclusion Use of palliative care during SCD-related hospitalisations is increasing but remains low. Disparities associated with race and gender exist for use of palliative care services during SCD-related hospitalisation. Further studies are needed to guide evidence-based palliative care interventions for more comprehensive and equitable care of adult patients with SCD.
AB - Objective Sickle cell disease (SCD) is a highly morbid condition notable for recurrent hospitalisations due to vaso-occlusive crises and complications of end organ damage. Little is known about the use of inpatient palliative care services in adult patients with SCD. This study aims to evaluate inpatient palliative care use during SCD-related hospitalisations overall and during terminal hospitalisations. We hypothesise that use of palliative care is low in SCD hospitalisations. Design A retrospective cross-sectional study using data from the National Inpatient Sample from 2008 to 2017 was conducted. Setting US hospitals from 47 states and the District of Columbia. Participants Patients >18 years old hospitalised with a primary or secondary International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or ICD-10-CM diagnosis of SCD were included. Primary and secondary outcome measures Palliative care service use (documented by ICD-9-CM and ICD-10-CM diagnosis codes V66.7 and Z51.5). Results 987 555 SCD-related hospitalisations were identified, of which 4442 (0.45%) received palliative care service. Palliative care service use increased at a rate of 9.2% per year (95% CI 5.6 to 12.9). NH-black and Hispanic patients were 33% and 53% less likely to have palliative care services compared with NH-white patients (OR 0.67; 95% CI 0.45 to 0.99 and OR 0.47; 95% CI 0.26 to 0.84). Female patients (OR 0.40; 95% CI 0.21 to 0.76), Medicaid use (OR 0.40; 95% CI 0.21 to 0.78), rural (OR 0.47; 95% CI 0.28 to 0.79) and urban non-teaching hospitals (OR 0.61; 95% CI 0.47 to 0.80) each had a lower likelihood of palliative care services use. Conclusion Use of palliative care during SCD-related hospitalisations is increasing but remains low. Disparities associated with race and gender exist for use of palliative care services during SCD-related hospitalisation. Further studies are needed to guide evidence-based palliative care interventions for more comprehensive and equitable care of adult patients with SCD.
KW - adult palliative care
KW - anaemia
KW - haematology
UR - http://www.scopus.com/inward/record.url?scp=85136070349&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-057361
DO - 10.1136/bmjopen-2021-057361
M3 - Article
C2 - 35973707
AN - SCOPUS:85136070349
SN - 2044-6055
VL - 12
JO - BMJ Open
JF - BMJ Open
IS - 8
M1 - e057361
ER -