Trends in hospice and palliative care consults initiated in the emergency department: An eight-year utilization analysis

Trends in hospice and palliative care consults initiated in the emergency department: An eight-year utilization analysis
The American Journal of Emergency Medicine; by Satheesh Gunaga, Abe Al-Hage, Alyssa Buchheister, Harish Neelam, Jessica Corcoran, Michael Welchans, Kirby Swan, Mahmoud Awada, Joseph Miller, Fabrice Mowbray; 8/25
Emergency departments (EDs) play a central role in end-of-life care, yet the early integration of hospice and palliative care (HPC) is often underutilized. A total of 8,055 HPC consults were ordered for 6,370 unique patients. The average age was 78.1 years, with 56.4 % female and 75.0 % White. Of the cohort, 91.7 % were admitted, 5.3 % discharged home, and 53.2 % died in-hospital. HPC consults increased from 369 in 2016 to 1,355 in 2023 (367 % increase ... ). The ratio of hospice to palliative care consults reversed from 1.5:1 in 2016 to 1:1.9 in 2023.
Assistant Editor's note: In the early years of hospice, and then later with the emergence of palliative care, consults for advanced illness in the ED rarely ever occurred. But that is no longer true as our demographics have changed, as well as where people seek care and how it is reimbursed. Hospice and palliative care programs have emerging opportunities to partner with EDs in order to provide these kinds of vital services to patients in need.