Mallow Peter J, Savarino Pierson
Xavier University, Cincinnati, OH, USA.
Health Serv Insights. 2025 Apr 11;18:11786329251331779. doi: 10.1177/11786329251331779. eCollection 2025.
The introduction of the International Classification of Diseases 10th Revision (ICD-10) code Z71.81 in 2015 enabled the systematic documentation of spiritual and religious counseling (SRC) in hospital settings, opening avenues for research into its effect on patient outcomes and healthcare resource utilization. Religion and spirituality are integral to many patients' lives, influencing their well-being, recovery and health outcomes. Despite its potential to improve outcomes, limited data exist on SRC's application and effect in the hospital setting.
This study evaluated the frequency and characteristics of SRC documentation and explored its associations with patient outcome in the inpatient hospital setting.
A retrospective observational study.
Data were drawn from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample from 2016 to 2021, encompassing all United States hospitalizations excluding military and specialty facilities. This dataset provided a nationally representative sample of all hospitalizations. Inpatient visits coded for SRC were identified using ICD-10 Z71.81. Statistical analyses assessed descriptive trends and associations with outcomes such as mortality, length of stay (LOS), and healthcare charges.
The analysis included 5910 SRC-documented inpatient visits from 89 hospitals. SRC was frequently documented for patients with severe or terminal conditions, as evidenced by a significantly higher mortality rate (10.9% vs 2.3% overall). Temporal trends demonstrated a steady, albeit modest, increase in SRC documentation over the study period. While SRC utilization varied across demographic groups, differences in access and outcomes were evident.
SRC is primarily utilized in complex, high-mortality cases, underscoring its role in holistic care for severely ill patients. The disparities observed highlight the need for standardized SRC documentation and equitable access to SRC. Future research should investigate the clinical and economic impacts of SRC to enhance patient-centered care in alignment with value-based care practices.
2015年国际疾病分类第十次修订版（ICD - 10）代码Z71.81的引入，使得医院环境中精神和宗教咨询（SRC）的系统记录成为可能，为研究其对患者结局和医疗资源利用的影响开辟了道路。宗教和精神信仰是许多患者生活中不可或缺的一部分，影响着他们的幸福感、康复情况和健康结局。尽管SRC有改善结局的潜力，但关于其在医院环境中的应用和效果的数据有限。
本研究评估了SRC记录的频率和特征，并探讨了其与住院医院环境中患者结局的关联。
一项回顾性观察研究。
数据取自2016年至2021年医疗成本和利用项目的全国住院样本，涵盖美国所有住院情况，但不包括军事和专科设施。该数据集提供了所有住院情况的全国代表性样本。使用ICD - 10 Z71.81识别编码为SRC的住院就诊。统计分析评估了描述性趋势以及与死亡率、住院时间（LOS）和医疗费用等结局的关联。
分析包括来自89家医院的5910次有SRC记录的住院就诊。SRC经常记录在患有严重或终末期疾病患者的病历中，这一点从显著更高的死亡率（总体为10.9%对2.3%）中得到证明。时间趋势表明，在研究期间SRC记录呈稳定但适度的增长。虽然SRC的使用在不同人口群体中有所不同，但在可及性和结局方面的差异很明显。
SRC主要用于复杂的、高死亡率的病例，凸显了其在重症患者整体护理中的作用。观察到的差异突出了标准化SRC记录和公平获得SRC的必要性。未来的研究应调查SRC的临床和经济影响，以根据基于价值的护理实践加强以患者为中心的护理。
