title: Timing of Palliative Care Consultations and Recommendations: Understanding the Variability.
abstract: Palliative care consultation teams (PCCTs) provide care that enhances quality of life. The effectiveness of PCCTs depends, however, on their timely utilization by other providers. The goal of this study was to examine the timing of palliative care consultation requests and responses at a single Veteran Affairs Medical Center. The median interval between admission and consultation request was 5 days (range = 0-73 days). The median interval between consultation request and death was 23 days (range = 0-847 days). In logistic regressions, timing variables were not significant predictors of whether consultation recommendations were made or implemented. There is substantial variability in when patients receive a palliative care consultation. Many patients receive palliative care within the first week of hospitalization and their final month of life.
authors.affiliation: Department of Psychology, Washington University, St Louis, MO, USA elissa.kozlov@wustl.edu.
authors.forename: Elissa
authors.initials: E
authors.lastname: Kozlov
authors.affiliation: Department of Psychology, Washington University, St Louis, MO, USA.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Carpenter
authors.affiliation: Palliative Care Service, St Louis Veterans Affairs Medical Center, St Louis, MO, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Thorsten
authors.affiliation: Palliative Care Service, St Louis Veterans Affairs Medical Center, St Louis, MO, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Heiland
authors.affiliation: Palliative Care Service, St Louis Veterans Affairs Medical Center, St Louis, MO, USA.
authors.forename: Anupam
authors.initials: A
authors.lastname: Agarwal
mesh_terms: D006760:Hospitalization; D006801:Humans; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care / Q000592:standards*; D010347:Patient Care Planning / Q000592:standards*; D010348:Patient Care Team / Q000592:standards*; D011788:Quality of Life; D012017:Referral and Consultation; D013997:Time Factors
keywords: health services misuse; palliative care; palliative medicine; palliative therapy