title: Palliative care patients in the emergency department.
abstract: Although end-of-life care is not a primary function of the emergency department (ED), in reality, many access this department in the later stages of illness. In this study, ED use by patients registered with the Capital Health Integrated Palliative Care Service (CHIPCS) is examined and CHIPCS patient characteristics associated with ED use identified. Overall, 27% of patients made at least one ED visit while registered with CHIPCS; 54% of these resulted in a hospital admission. ED visiting was not associated with time of day or day of the week. Multivariate logistic regression results suggest older patients were significantly less likely to make an ED visit. Making an ED visit was associated with hospital death, rural residence (particularly for women), and having a parent or relative other than a spouse or child as the primary caregiver. Further research may suggest strategies to reduce unnecessary ED visits during the end of life.
authors.affiliation: Dalhousie University, Department of Family Medicine, Halifax.
authors.forename: Beverley J
authors.initials: BJ
authors.lastname: Lawson
authors.forename: Frederick I
authors.initials: FI
authors.lastname: Burge
authors.forename: Paul
authors.initials: P
authors.lastname: Mcintyre
authors.forename: Simon
authors.initials: S
authors.lastname: Field
authors.forename: David
authors.initials: D
authors.lastname: Maxwell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008134:Long-Term Care / Q000458:organization & administration*; D008297:Male; D015999:Multivariate Analysis; D009674:Nova Scotia / Q000453:epidemiology; D010166:Palliative Care / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D015996:Survival Rate