Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States
Charat Thongprayoon,
Wisit Kaewput,
Tananchai Petnak,
Oisin A. O’Corragain,
Boonphiphop Boonpheng,
Tarun Bathini,
Saraschandra Vallabhajosyula,
Pattharawin Pattharanitima,
Ploypin Lertjitbanjong,
Fawad Qureshi,
Wisit Cheungpasitporn
Affiliations
Charat Thongprayoon
Department of Medicine, Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN 55905, USA
Wisit Kaewput
Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok 10400, Thailand
Tananchai Petnak
Division of Pulmonary and Pulmonary Critical Care Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Oisin A. O’Corragain
Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA 19140, USA
Boonphiphop Boonpheng
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
Tarun Bathini
Department of Internal Medicine, University of Arizona, Tucson, AZ 85719, USA
Saraschandra Vallabhajosyula
Section of Interventional Cardiology, Department of Medicine, Division of Cardiovascular Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
Pattharawin Pattharanitima
Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand
Ploypin Lertjitbanjong
Division of Pulmonary, Critical Care and Sleep Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
Fawad Qureshi
Department of Medicine, Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN 55905, USA
Wisit Cheungpasitporn
Department of Medicine, Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN 55905, USA
Background: This study aimed to determine the rates of inpatient palliative care service use and assess the impact of palliative care service use on in-hospital treatments and resource utilization in hospital admissions for hepatorenal syndrome. Methods: Using the National Inpatient Sample, hospital admissions with a primary diagnosis of hepatorenal syndrome were identified from 2003 through 2014. The primary outcome of interest was the temporal trend and predictors of inpatient palliative care service use. Logistic and linear regression was performed to assess the impact of inpatient palliative care service on in-hospital treatments and resource use. Results: Of 5571 hospital admissions for hepatorenal syndrome, palliative care services were used in 748 (13.4%) admissions. There was an increasing trend in the rate of palliative care service use, from 3.3% in 2003 to 21.1% in 2014 (p Conclusion: Although there was a substantial increase in the use of palliative care service in hospitalizations for hepatorenal syndrome, inpatient palliative care service was still underutilized. The use of palliative care service was associated with reduced resource use.
