POLST Registration and Associated Outcomes Among Veterans With Advanced-Stage Lung Cancer
| Autor: | Kelly C. Vranas, Sara E. Golden, Donald R. Sullivan, Shannon M. Nugent, Dana Zive, Linda Ganzini, Christopher G. Slatore |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Advance care planning medicine.medical_specialty Lung Neoplasms Palliative care Article Cohort Studies Advance Care Planning Oregon 03 medical and health sciences 0302 clinical medicine 030502 gerontology medicine Humans Intensive care medicine Lung cancer Aged Retrospective Studies Veterans Terminal Care business.industry Advanced stage General Medicine Middle Aged medicine.disease humanities Socioeconomic Factors 030220 oncology & carcinogenesis Female 0305 other medical science business |
| Zdroj: | Am J Hosp Palliat Care |
| ISSN: | 1938-2715 1049-9091 |
| Popis: | INTRODUCTION: The Oregon Physicians Orders for Life-Sustaining Treatment (POLST) Program allows patients with advancer illness to document end-of-life (EOL) care preferences. We examiner the characteristics and associated EOL care among Veterans with and without a registered POLST. METHODS: Retrospective, cohort study of advancer-stage (IIIB and IV) patients with lung cancer who were diagnosed between 2008 and 2013 as recorded in the VA Central Cancer Registry. We examiner a subgroup of 346 Oregon residents. We obtainer clinical and sociodemographic variables from the VA Corporate Data Warehouse and EOL preferences from the Oregon POLST Registry. We comparer hospice enrollment and place of death between those with and without a registered POLST. RESULTS: Twenty-two (n = 77) percent of our cohort had registered POLST forms. Comparer to those without a registered POLST, Veterans with a POLST had a higher income ($51 456 vs $48 882) and longer time between diagnosis and death (223 rays vs 119 rays). Those with a registered POLST were more likely to be enroller in hospice (adjuster odds ratio [aOR] = 2.37, 95% confidence interval [CI]: 1.01–5.54) and less likely to die in a VA facility (aOR = 0.27, 95% CI: 0.12–0.59). CONCLUSION: There was low submission to the POLST Registry among Veterans who receiver care in Veterans’ Health Administration. Veterans who had a registered POLST were more likely to be enroller in hospice and less likely to die in a VA care setting. The POLST may improve metrics of high-quality EOL care; however, opportunities for improvement in submission and implementation within the VA exist. |
| Databáze: | OpenAIRE |
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