The effects of the Palliative Medicine Consultation on the DNR status of African Americans in a safety-net hospital.

The effects of the Palliative Medicine Consultation on the DNR status of African Americans in a safety-net hospital.

Sacco J; Deravin Carr DR; Viola D

The American Journal Of Hospice & Palliative Care

2013

Female; Humans; Male; Critical Illness; Prognosis; Aged; Middle Aged; Communication; Poverty Areas; Attitudes; retrospective studies; Health Knowledge; DNAR; Resuscitation Orders; Palliative Care/mt [Methods]; Advance Directives/eh [Ethnology]; Palliative Care/og [Organization & Administration]; New York City; Advance Directives/sn [Statistics & Numerical Data]; African Americans/statistics & numerical data; Hispanic Americans/sn [Statistics & Numerical Data]; Palliative Care/sn [Statistics & Numerical Data]; Practice/eh [Ethnology]; Referral and Consultation/statistics & numerical data

OBJECTIVE: To examine the effectiveness of palliative medicine consultation on completion of advance directives/do-not-resuscitate (DNR) orders by racial/ethnic minorities., METHOD: A sample of 1999 seriously ill African American and Hispanic inpatients was obtained from the Palliative Medicine Consultation database (n = 2972). Associations between race/ethnicity and diagnosis and documentation of DNR status on admission and discharge were examined., RESULTS: Cancer was the primary diagnosis, 34.5%. Among patients with a consultation, 98% agreed to discuss advance directives; 65% of African Americans and 70% of Hispanics elected DNR status. Inpatient deaths were 46%; 74% of decedents agreed to DNR orders. Discharged patients referred to hospice were 29%., CONCLUSION: Palliative medicine consultations resulted in timely completion of DNR orders and were positively associated with DNR election and hospice enrollment.

2013

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