title: Race as a Predictor of Palliative Care Referral Time, Hospice Utilization, and Hospital Length of Stay: A Retrospective Noncomparative Analysis.
abstract: BACKGROUND
  Palliative care is associated with significant benefits, including reduced pain and suffering, an increased likelihood of patients dying in their preferred location, and decreased health-care expenditures. Racial and ethnic disparities are well-documented in hospice use and referral patterns; however, it is unclear whether these disparities apply to inpatient palliative care services.
  
  
  OBJECTIVE
  To determine if race is a significant predictor of time to inpatient palliative care consult, patient enrollment in hospice, and patients' overall hospital length of stay among patients of an inpatient palliative care service.
  
  
  METHODS
  Retrospective noncomparative analysis.
  
  
  METHODS
  Urban academic medical center in the United States.
  
  
  METHODS
  3207 patients referred to an inpatient palliative care service between March 2006 and April 2015.
  
  
  METHODS
  Time to palliative care consult, disposition of hospice/not hospice (excluding patients who died), and hospital length of stay among patients by racial (Asian, black, Native American/Eskimo, Hispanic, white, Unknown) and ethnic (Hispanic/Latino, non-Hispanic, Unknown) background.
  
  
  RESULTS
  Race was not a significant predictor of time to inpatient palliative care consult, discharge to hospice, or hospital length of stay. Similarly, black/white, Hispanic/white, and Asian/white variables were not significant predictors of hospice enrollment ( Ps > .05).
  
  
  CONCLUSIONS
  Study was conducted at 1 urban academic medical center, limiting generalizability; hospital race and ethnicity categorizations may also limit interpretation of results.
  
  
  CONCLUSIONS
  In this urban hospital, race was not a predictor of time to inpatient palliative care service consult, discharge to hospice, or hospital length of stay. Confirmatory studies of inpatient palliative care services in other institutions are needed.
authors.affiliation: 1 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Brooke
authors.initials: B
authors.lastname: Worster
authors.affiliation: 1 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Declan Kennedy
authors.initials: DK
authors.lastname: Bell
authors.affiliation: 1 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Vibin
authors.initials: V
authors.lastname: Roy
authors.affiliation: 1 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Cunningham
authors.affiliation: 1 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Marianna
authors.initials: M
authors.lastname: LaNoue
authors.affiliation: 1 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Parks
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States; D014505:Urban Population; D055815:Young Adult
keywords: disparities; hospice care; inpatient palliative care; palliative care; palliative care consult; race and ethnicity; urban