Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, Colorado, USA.
Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA.
J Palliat Med. 2024 Jul;27(7):916-921. doi: 10.1089/jpm.2023.0610. Epub 2024 Jun 21.
The objective of this study was to examine the association between portal use and end-of-life (EOL) outcomes in the last year of life. A retrospective cohort ( = 6,517) study at Kaiser Permanente Colorado among adults with serious illness deceased between January 1, 2016, and June 30, 2019. Portal use was categorized into engagement types: no use, nonactive, active without a provider, and active with a provider. EOL outcomes were hospitalizations in the month before death, last-year advance directive completion, and hospice use. Association between EOL outcomes and levels of portal use was assessed using χ statistics and generalized linear models. Higher portal engagement types were associated with higher rates of hospitalizations ( = 0.0492), advance directive completion ( = 0.0226), and hospice use ( = 0.0070). Portal use in the last year of life was associated with increases in a poor EOL outcome, hospitalizations, and beneficial EOL outcomes, advance directives, and hospice care.
本研究旨在探讨在生命的最后一年中，使用门户与临终结局之间的关联。这是一项在科罗拉多州 Kaiser Permanente 进行的回顾性队列（=6517）研究，纳入了 2016 年 1 月 1 日至 2019 年 6 月 30 日期间去世的患有严重疾病的成年人。将门户使用分为以下几种参与类型：未使用、非活跃、无提供者的活跃和有提供者的活跃。临终结局包括死亡前一个月的住院情况、去年预立医疗指示的完成情况和临终关怀的使用情况。使用卡方检验和广义线性模型评估临终结局与门户使用水平之间的关联。更高的门户参与类型与更高的住院率（=0.0492）、预立医疗指示的完成率（=0.0226）和临终关怀使用率（=0.0070）相关。生命最后一年的使用门户与较差的临终结局、住院和有益的临终结局、预立医疗指示和临终关怀相关。
