Department of Health Services, Policy and Practice, Center for Gerontology and Health Care Research, Brown University School of Public Health , Providence, Rhode Island.
J Palliat Med. 2018 Feb;21(2):188-193. doi: 10.1089/jpm.2017.0099. Epub 2017 Aug 17.
Little is known about nursing home (NH) residents who receive palliative care (PC) consults in the United States.
Separately by short versus long (≥90 days) stays, to describe NH residents with PC consults compared to a prevalent NH sample.
Descriptive longitudinal study.
SETTING/SUBJECTS: NH residents in 2008-2010 in 54 NHs.
Resident characteristics came from merged Medicare and NH data from the Centers for Medicare and Medicaid Services and consult information from two PC organizations that were the sole PC consult providers in the study NHs.
Four percent of all NH residents received a PC consult during the study period. Two-thirds had short NH stays, and 81% of short- and 27% of long-stay consult recipients were on the Medicare skilled nursing facility (SNF) benefit at the time of initial consult. Short- and long-stay NH residents with PC consults differed not only, in many respects, from NH residents generally but also from each other. Despite these differences, half of short-stay and 57% of long-stay residents were alive six months after initial consults. Residents dead at six months died at 33.5 and 34.5 median days (respectively) after initial consults. At six months, 65% of surviving short-stay consult recipients were in the community without hospice, while 59% of long-stay residents were in the NH without hospice or Medicare SNF care.
The high rates of SNF care and six-month survival among NH recipients of PC consults demonstrate the utility of these consults before Medicare hospice eligibility or use.
在美国，对于接受姑息治疗（PC）咨询的疗养院（NH）居民知之甚少。
分别通过短期（<90 天）和长期（≥90 天）入住，来描述接受 PC 咨询的 NH 居民与普遍 NH 样本相比的情况。
描述性纵向研究。
地点/受试者： 2008-2010 年，54 家 NH 中的 NH 居民。
居民特征来自医疗保险和 NH 数据的合并，来自医疗保险和医疗补助服务中心，以及来自两个 PC 组织的咨询信息，这两个组织是研究 NH 中唯一的 PC 咨询提供者。
在研究期间，4%的 NH 居民接受了 PC 咨询。三分之二的 NH 入住时间较短，81%的短期和 27%的长期咨询接受者在初始咨询时都享有医疗保险熟练护理设施（SNF）福利。短期和长期接受 PC 咨询的 NH 居民不仅在许多方面与 NH 居民一般不同，而且彼此之间也不同。尽管存在这些差异，短期入住的居民中有一半，长期入住的居民中有 57%在初始咨询后六个月仍然存活。六个月后死亡的居民在初始咨询后分别死亡 33.5 天和 34.5 天中位数。在六个月时，65%存活的短期咨询接受者在社区中没有接受临终关怀，而 59%的长期咨询接受者在 NH 中没有接受临终关怀或 Medicare SNF 护理。
接受 PC 咨询的 NH 居民的 SNF 护理率和六个月生存率较高，表明这些咨询在 Medicare 临终关怀资格或使用之前具有实用性。
