title: The effects of the Palliative Medicine Consultation on the DNR status of African Americans in a safety-net hospital.
abstract: OBJECTIVE
  To examine the effectiveness of palliative medicine consultation on completion of advance directives/do-not-resuscitate (DNR) orders by racial/ethnic minorities.
  
  
  METHODS
  A sample of 1999 seriously ill African American and Hispanic inpatients was obtained from the Palliative Medicine Consultation database (n = 2972). Associations between race/ethnicity and diagnosis and documentation of DNR status on admission and discharge were examined.
  
  
  RESULTS
  Cancer was the primary diagnosis, 34.5%. Among patients with a consultation, 98% agreed to discuss advance directives; 65% of African Americans and 70% of Hispanics elected DNR status. Inpatient deaths were 46%; 74% of decedents agreed to DNR orders. Discharged patients referred to hospice were 29%.
  
  
  CONCLUSIONS
  Palliative medicine consultations resulted in timely completion of DNR orders and were positively associated with DNR election and hospice enrollment.
authors: Palliative Medicine Consultation Service/Hospice Inpatient Unit, Bronx Lebanon Hospital Center, Bronx, NY, USA.
authors: Joseph
authors: J
authors: Sacco
authors: Dana R
authors: DR
authors: Deravin Carr
authors: Deborah
authors: D
authors: Viola
mesh_terms: D016223:Advance Directives / Q000208:ethnology* / Q000706:statistics & numerical data; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D003142:Communication; D016638:Critical Illness; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D010166:Palliative Care / Q000379:methods / Q000458:organization & administration* / Q000706:statistics & numerical data; D011204:Poverty Areas; D011379:Prognosis; D012017:Referral and Consultation / Q000706:statistics & numerical data; D016414:Resuscitation Orders; D012189:Retrospective Studies