For adult patients in the intensive care unit (ICU), the availability of hospital-based palliative care is not associated with in-hospital treatment intensity. The study was published in the Annals of the American Thoracic Society.

Researchers conducted a retrospective study of adult ICU patients to examine the correlation between the availability of hospital-based palliative care and treatment intensity. Data were included for 1,025,503 ICU patients in 151 hospitals.

A retrospective cohort study of adult ICU patients in New York State hospitals, 2008–2014. Multilevel regression was used to assess the relationship between the availability of hospital-based palliative care during the year of admission and hospital length of stay, use of mechanical ventilation, dialysis, and artificial nutrition, placement of a tracheostomy or gastrostomy tube, days in ICU and discharge to hospice.

Patients In Hospitals

The researchers found that 79.5% of the patients received care in a hospital with a palliative care program. Patients in hospitals with and without palliative care programs had a similar length of stay, with a statistically significant, but not clinically meaningful, difference (six versus six days; adjusted rate ratio, 1.04; 95% confidence interval, 1.03 to 1.05; P < 0.001); other health care use outcomes were also similar.

Compared to patients in hospitals without palliative care programs, patients in hospitals with palliative care programs were more likely to be discharged to hospice (1.7 versus 1.4%; adjusted odds ratio, 1.46; 95% confidence interval, 1.30 to 1.64; P < 0.001).

Critically Ill

Currently, the measurable benefit of palliative care programs for critically ill patients may be the increased use of hospice facilities, as opposed to decreased health care use during an ICU-associated hospitalization.

The availability of hospital-based palliative care was not associated with differences in in-hospital treatment intensity, but it was associated with significantly increased hospice use for ICU patients.

Currently, the measurable benefit of palliative care programs for critically ill patients may be the increased use of hospice facilities, as opposed to decreased health care use during an ICU-associated hospitalization.