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Text
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<a href="http://doi.org/10.1089/jpm.2011.0401" target="_blank" rel="noreferrer">http://doi.org/10.1089/jpm.2011.0401</a>
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Title
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Survival duration among patients with a noncancer diagnosis admitted to a palliative care unit: a retrospective study
Publisher
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Journal Of Palliative Medicine
Date
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2012
Subject
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Female; Humans; Male; retrospective studies; Palliative Care; Terminally Ill; Adult; Prognosis; Medical Audit; Aged; Middle Aged; Length of Stay; Ontario; Survival Analysis; Regression Analysis; 80 and over
Creator
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Downar J; Chou Yang-Chieh; Ouellet D; La Delfa Ignazio; Blacker S; Bennett M; Petch C; Cheng SM
Description
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BACKGROUND: Palliative care unit (PCU) beds are a limited resource in Canada, so PCU admission is restricted to patients with a short prognosis. Anecdotally, PCUs further restrict admission of patients with noncancer diagnoses out of fear that they will "oversurvive" and reduce bed availability. This raises concerns that noncancer patients have unequal access to PCU resources. PURPOSE/METHODS: To clarify survival duration of patients with a noncancer diagnosis, we conducted a retrospective review of all admissions to four PCUs in Toronto, Canada, over a 1-year period. We measured associations between demographic data, prognosis, Palliative Performance Score (PPS), length of stay (LOS), and waiting time. RESULTS: We collected data for 1000 patients, of whom 21% had noncancer diagnoses. Noncancer patients were older, with shorter prognoses and lower PPS scores on admission. Noncancer patients had shorter LOS (14 versus 24, p<0.001) than cancer patients and a similar likelihood of being discharged alive to cancer patients. Noncancer patients had a trend to lower LOS across a broad range of demographic, diagnostic, prognostic, and PPS categories. Multivariable analysis showed that LOS was not associated with the diagnosis of cancer (p=0.36). DISCUSSION/CONCLUSION: Noncancer patients have a shorter LOS than cancer patients and a similar likelihood of being discharged alive from a PCU than cancer patients, and the diagnosis of cancer did not correlate with survival in our study population. Our findings demonstrate that noncancer patients are not "oversurviving," and that referring physicians and PCUs should not reject or restrict noncancer referrals out of concern that these patients are having a detrimental impact on PCU bed availability.
Identifier
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<a href="http://doi.org/10.1089/jpm.2011.0401" target="_blank" rel="noreferrer">10.1089/jpm.2011.0401</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2012
80 And Over
Adult
Aged
Backlog
Bennett M
Blacker S
Cheng SM
Chou Yang-Chieh
Downar J
Female
Humans
Journal Article
Journal of Palliative Medicine
La Delfa Ignazio
Length Of Stay
Male
Medical Audit
Middle Aged
Ontario
Ouellet D
Palliative Care
Petch C
Prognosis
Regression Analysis
Retrospective Studies
Survival Analysis
Terminally Ill