Author + information
- Kasra Moazzami,
- Elena Dolmatova,
- James Maher,
- Pallavi Solanki,
- Marc Klapholz and
- Alfonso Waller
Background: The latest American Heart Association guidelines have recommended palliative/hospice care in selected patients with end-stage heart failure (HF). However, limited information exists regarding the trends in utilization of hospice care in this patient population.
Methods: Data from the Nationwide (National) Inpatient Sample for patients with the primary diagnosis of HF between 2003-2012 were analyzed using cross-tabulations and multivariate regressions.
Results: Among a total of 10,471,535 hospital admissions with HF, the rate of in-patient palliative care increased more than 7 fold from 0.27% in 2003 to 2.14% in 2012 (P<0.001). Discharge disposition to hospice care also showed a steady increase from 0.83% in 2003 to 2.81% in 2012 (P<0.001). Multivariable logistic regression analysis revealed age more than 65 years (OR, 2.56, 95% CI 1.47-4.43, P<0.001), white race (OR, 1.62, 95% CI 1.42-1.85, P<0.001), larger hospital bed-size (OR, 1.16, 95% CI 1.06-1.32, P=0.003), and teaching hospitals (OR, 1.48, 95% CI 1.22-1.81, P<0.001) were associated with higher discharge dispositions to hospice care.
Conclusions: Between the years of 2003 and 2012, a steady increase in the rate of in-patient palliative care and disposition to hospice care were observed among patients admitted with a primary diagnosis of HF in the United States. A number of patient and hospital level characteristics were identified to be associated with higher discharge dispositions to hospice care. There is racial disparity amongst patients with HF referred for hospice. Further studies are needed to understand the determinants of these disparities, reduce these disparities and improve the care of minorities with HF.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Heart Failure: Evaluating Strategies to Prevent Readmissions
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1163-288
- 2017 American College of Cardiology Foundation