Honoring Preferences—The Consistency Between End-of-Life Care and a Veteran’s Goal for Comfort Care

This study examined the alignment between Veterans’ end-of-life care and a Life-Sustaining Treatment (LST) goal “to be comfortable.” It includes Veterans with VA inpatient or community living center stays overlapping July 2018--January 2019, with a LST template documented by January 31, 2019, and wh...

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Detalles Bibliográficos
Autores principales: Carpenter, Joan, Scott, Winifred, Ersek, Mary, Levy, Cari, Cohen, Jennifer, Foglia, Mary Beth, Phibbs, Ciarian, Miller, Susan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Abstracts
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7743148/
http://dx.doi.org/10.1093/geroni/igaa057.2711
Descripción
Sumario:This study examined the alignment between Veterans’ end-of-life care and a Life-Sustaining Treatment (LST) goal “to be comfortable.” It includes Veterans with VA inpatient or community living center stays overlapping July 2018--January 2019, with a LST template documented by January 31, 2019, and who died by April 30, 2019 (N = 18,163). Using VA and Medicare data, we found 80% of decedents with a comfort care goal received hospice and 57% a palliative care consult (compared to 57% and 46%, respectively, of decedents without a comfort care goal). Using multivariate logistic regression, a comfort care goal was associated with significantly lower odds of EOL hospital or ICU use. In the last 30 days of life, Veterans with a comfort care goal had 43% lower odds (AOR 0.57; 95% CI: 0.51, 0.64) of hospitalization and 46% lower odds of ICU use (AOR 0.54; 95% CI: 0.48, 0.61).

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