Socioeconomic Trends in Palliative Care: A Six-Year Study.

Autor:	Sodoma A; Internal Medicine, South Shore University Hospital, Bay Shore, USA., Naseeb MW; Internal Medicine, South Shore University Hospital, Bay Shore, USA., Greenberg S; Anesthesia and Critical Care, Renaissance School of Medicine, Stony Brook University, Stony Brook, USA., Knott NJ; College of Osteopathic Medicine, New York Institute of Technology, Jonesboro, USA., Arias J; Physical Medicine and Rehabilitation, NYC Health and Hospitals, Queens, USA., Skulikidis A; Internal Medicine, South Shore University Hospital, Bay Shore, USA., Makaryus M; Palliative Care, South Shore University Hospital, Bay Shore, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 11; Vol. 16 (10), pp. e71274. Date of Electronic Publication: 2024 Oct 11 (Print Publication: 2024).
DOI:	10.7759/cureus.71274
Abstrakt:	The use of palliative care (PC) is on the rise in the USA, with clear benefits to patients, families, hospitals, and insurance companies. Our study investigates trends in PC utilization, focusing on socioeconomic characteristics. The National Inpatient Sample (NIS) from 2015 to 2020 was used to identify adults hospitalized in the United States (US). International Classification of Diseases, Tenth Revision (ICD-10), was used for PC encounters, code Z51.5. An equal number of random records, stratified by year and without this code, were selected to serve as controls. Records were analyzed for baseline characteristics using a chi-square test. Adjusted odds ratios (ORs) of receiving PC were calculated using multivariate logistic regression. Men were more likely to receive PC consults (OR: 1.07, confidence interval (CI): 1.06-1.08). Medicare/Medicaid holders' PC access was limited compared to private insurance holders (0.89, 0.86-0.93). Racial minorities, particularly Hispanics (0.9, 0.86-0.95) and Blacks (0.83, 0.77-0.88), were less likely to engage in PC. Compared to urban teaching hospitals, rural hospitals had a decreased rate of PC utilization (0.53, 0.49-0.57). Smaller hospitals had significantly fewer PC referrals than large hospitals (0.80, 0.76-0.85). A lower socioeconomic status was associated with a reduced propensity to utilize PC services compared to an upper socioeconomic status (0.91, 0.87-0.96). Our analysis shows that socioeconomic factors strongly influence PC access. This highlights important inequities that require measures to improve equitable PC access across demographic groups. Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Sodoma et al.)
Databáze:	MEDLINE
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