Factors Associated with Re-Enrollment of Patients from a Specialist Community Palliative Care Service.

Ho, GKE; Chye, R; Jang, D; Sutton, P; Sullivan, S; Seah, D

Factors Associated with Re-Enrollment of Patients from a Specialist Community Palliative Care Service.

Ho, GKE Chye, R Jang, D Sutton, P Sullivan, S Seah, D

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Publisher:: MARY ANN LIEBERT, INC
Publication Type:: Journal Article
Citation:: Journal of palliative medicine, 2020, 23, (10), pp. 1342-1348
Issue Date:: 2020-10

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Field	Value	Language
dc.contributor.author	Ho, GKE
dc.contributor.author	Chye, R
dc.contributor.author	Jang, D
dc.contributor.author	Sutton, P
dc.contributor.author	Sullivan, S
dc.contributor.author	Seah, D
dc.date.accessioned	2021-05-04T23:05:00Z
dc.date.available	2021-05-04T23:05:00Z
dc.date.issued	2020-10
dc.identifier.citation	Journal of palliative medicine, 2020, 23, (10), pp. 1342-1348
dc.identifier.issn	1096-6218
dc.identifier.issn	1557-7740
dc.identifier.uri	http://hdl.handle.net/10453/148618
dc.description.abstract	<b><i>Objective:</i></b> The aim of this study was to describe the patterns of discharge and re-enrollment to a community palliative care service, and to identify factors associated with re-enrollment. <b><i>Background:</i></b> Community-based palliative care is a limited resource. The evidence base to guide discharge practices from community palliative care services is limited. <b><i>Methods:</i></b> A retrospective audit of the electronic medical records for all patients discharged from the Sacred Heart Community Palliative Care Service (SHCPCS), Sydney, from July 2010 to July 2016 was conducted. Patients were excluded if they were discharged due to death, transferred out of catchment area, declined the service, transferred to another hospital, or were referred inappropriately. Data extracted included sociodemographic variables, living situation, diagnoses, and discharge and re-enrollment details. Using binary logistic regression analysis, predictive factors, including socio-demographic characteristics, diagnosis and length of episode of care, were evaluated. <b><i>Results:</i></b> Of the 739 patients who met the inclusion criteria, 42 (5.7%) were re-enrolled to the service. The median length of the initial episode of care was 65 days and the median timeframe between discharge and re-enrollment was 216 days. Patients living in residential care facilities (odds ratio [OR] 3.45; 95% confidence interval [CI] 1.28-9.28; <i>p</i> = 0.01) and those with malignant diagnoses (OR 2.22; 95% CI 1.00-4.93; <i>p</i> = 0.04) had higher rates of re-enrollment. <b><i>Discussion:</i></b> The proportion of patients re-enrolled to the service was low. Both patient factors and disease factors were associated with re-enrollment. Future prospective studies evaluating prognostic factors to assist with effective discharge processes and guidelines are warranted.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	MARY ANN LIEBERT, INC
dc.relation.ispartof	Journal of palliative medicine
dc.relation.isbasedon	10.1089/jpm.2019.0385
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Gerontology
dc.title	Factors Associated with Re-Enrollment of Patients from a Specialist Community Palliative Care Service.
dc.type	Journal Article
utslib.citation.volume	23
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
dc.date.updated	2021-05-04T23:04:59Z
pubs.issue	10
pubs.publication-status	Published
pubs.volume	23
utslib.citation.issue	10

Abstract:

Objective: The aim of this study was to describe the patterns of discharge and re-enrollment to a community palliative care service, and to identify factors associated with re-enrollment. Background: Community-based palliative care is a limited resource. The evidence base to guide discharge practices from community palliative care services is limited. Methods: A retrospective audit of the electronic medical records for all patients discharged from the Sacred Heart Community Palliative Care Service (SHCPCS), Sydney, from July 2010 to July 2016 was conducted. Patients were excluded if they were discharged due to death, transferred out of catchment area, declined the service, transferred to another hospital, or were referred inappropriately. Data extracted included sociodemographic variables, living situation, diagnoses, and discharge and re-enrollment details. Using binary logistic regression analysis, predictive factors, including socio-demographic characteristics, diagnosis and length of episode of care, were evaluated. Results: Of the 739 patients who met the inclusion criteria, 42 (5.7%) were re-enrolled to the service. The median length of the initial episode of care was 65 days and the median timeframe between discharge and re-enrollment was 216 days. Patients living in residential care facilities (odds ratio [OR] 3.45; 95% confidence interval [CI] 1.28-9.28; p = 0.01) and those with malignant diagnoses (OR 2.22; 95% CI 1.00-4.93; p = 0.04) had higher rates of re-enrollment. Discussion: The proportion of patients re-enrolled to the service was low. Both patient factors and disease factors were associated with re-enrollment. Future prospective studies evaluating prognostic factors to assist with effective discharge processes and guidelines are warranted.

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http://hdl.handle.net/10453/148618