Ten-year trends of palliative care utilization associated with multiple sclerosis patients in the United States from 2005 to 2014

Yongjae Lee, Ji Won Yoo, Le Hua, Pearl C. Kim, Sun Jung Kim, Jay J. Shen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Multiple sclerosis (MS) is a chronic neuro-inflammatory disease of the central nervous system, associated with accumulation of irreversible neurological disabilities through both inflammatory relapses and progressive neurodegeneration. Patients with debilitating MS could benefit from palliative care perspectives both during relapses that lead to transient disability as well as later in the disease course when significant physical and cognitive disability have accrued. However, no data about palliative care utilization trends of MS patients are available. We examined 10-year temporal trends of palliative care and assessed independent associations of palliative care with hospital utilization and cost using the 2005–2014 national inpatient sample. The national trends of palliative care utilization in MS patients increased by 120 times from 0.2% to 6.1% during 2005–2014, particularly with the dramatic single-year increase between 2010 (1.5%) and 2011 (4.5%). Moreover, the proportion of receiving palliative care in in-hospital death gradually increased from 7.7% in 2005 to 58.8% in 2014. Palliative care in MS inpatients may affect hospital utilization and charges in different ways. Hospital palliative care was associated with increased length of stay (LOS) (β = 0.444 days, p < 0.001) and in-hospital death (OR = 15.35, 95% CI [13.76, 17.12]), but associated with decreased hospital charges (β = −$2261, p < 0.001). In conclusion, the temporal trends of palliative care use in MS inpatients gradually increased with an exponential increase between 2010 and 2011 during 2005–2014, which is mostly attributed to patients with higher risk of in-hospital death. Moreover, palliative care was associated with reduced hospital charge with increased LOS and in-hospital death.

Original languageEnglish
Pages (from-to)13-19
Number of pages7
JournalJournal of Clinical Neuroscience
Volume58
DOIs
Publication statusPublished - 2018 Dec 1

Fingerprint

Palliative Care
Multiple Sclerosis
Hospital Charges
Inpatients
Length of Stay
Recurrence
Hospital Costs
Central Nervous System Diseases

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

@article{5d3d07fe86a04f38adccd23874dc5805,
title = "Ten-year trends of palliative care utilization associated with multiple sclerosis patients in the United States from 2005 to 2014",
abstract = "Multiple sclerosis (MS) is a chronic neuro-inflammatory disease of the central nervous system, associated with accumulation of irreversible neurological disabilities through both inflammatory relapses and progressive neurodegeneration. Patients with debilitating MS could benefit from palliative care perspectives both during relapses that lead to transient disability as well as later in the disease course when significant physical and cognitive disability have accrued. However, no data about palliative care utilization trends of MS patients are available. We examined 10-year temporal trends of palliative care and assessed independent associations of palliative care with hospital utilization and cost using the 2005–2014 national inpatient sample. The national trends of palliative care utilization in MS patients increased by 120 times from 0.2{\%} to 6.1{\%} during 2005–2014, particularly with the dramatic single-year increase between 2010 (1.5{\%}) and 2011 (4.5{\%}). Moreover, the proportion of receiving palliative care in in-hospital death gradually increased from 7.7{\%} in 2005 to 58.8{\%} in 2014. Palliative care in MS inpatients may affect hospital utilization and charges in different ways. Hospital palliative care was associated with increased length of stay (LOS) (β = 0.444 days, p < 0.001) and in-hospital death (OR = 15.35, 95{\%} CI [13.76, 17.12]), but associated with decreased hospital charges (β = −$2261, p < 0.001). In conclusion, the temporal trends of palliative care use in MS inpatients gradually increased with an exponential increase between 2010 and 2011 during 2005–2014, which is mostly attributed to patients with higher risk of in-hospital death. Moreover, palliative care was associated with reduced hospital charge with increased LOS and in-hospital death.",
author = "Yongjae Lee and Yoo, {Ji Won} and Le Hua and Kim, {Pearl C.} and Kim, {Sun Jung} and Shen, {Jay J.}",
year = "2018",
month = "12",
day = "1",
doi = "10.1016/j.jocn.2018.10.082",
language = "English",
volume = "58",
pages = "13--19",
journal = "Journal of Clinical Neuroscience",
issn = "0967-5868",
publisher = "Churchill Livingstone",

}

Ten-year trends of palliative care utilization associated with multiple sclerosis patients in the United States from 2005 to 2014. / Lee, Yongjae; Yoo, Ji Won; Hua, Le; Kim, Pearl C.; Kim, Sun Jung; Shen, Jay J.

In: Journal of Clinical Neuroscience, Vol. 58, 01.12.2018, p. 13-19.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ten-year trends of palliative care utilization associated with multiple sclerosis patients in the United States from 2005 to 2014

AU - Lee, Yongjae

AU - Yoo, Ji Won

AU - Hua, Le

AU - Kim, Pearl C.

AU - Kim, Sun Jung

AU - Shen, Jay J.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Multiple sclerosis (MS) is a chronic neuro-inflammatory disease of the central nervous system, associated with accumulation of irreversible neurological disabilities through both inflammatory relapses and progressive neurodegeneration. Patients with debilitating MS could benefit from palliative care perspectives both during relapses that lead to transient disability as well as later in the disease course when significant physical and cognitive disability have accrued. However, no data about palliative care utilization trends of MS patients are available. We examined 10-year temporal trends of palliative care and assessed independent associations of palliative care with hospital utilization and cost using the 2005–2014 national inpatient sample. The national trends of palliative care utilization in MS patients increased by 120 times from 0.2% to 6.1% during 2005–2014, particularly with the dramatic single-year increase between 2010 (1.5%) and 2011 (4.5%). Moreover, the proportion of receiving palliative care in in-hospital death gradually increased from 7.7% in 2005 to 58.8% in 2014. Palliative care in MS inpatients may affect hospital utilization and charges in different ways. Hospital palliative care was associated with increased length of stay (LOS) (β = 0.444 days, p < 0.001) and in-hospital death (OR = 15.35, 95% CI [13.76, 17.12]), but associated with decreased hospital charges (β = −$2261, p < 0.001). In conclusion, the temporal trends of palliative care use in MS inpatients gradually increased with an exponential increase between 2010 and 2011 during 2005–2014, which is mostly attributed to patients with higher risk of in-hospital death. Moreover, palliative care was associated with reduced hospital charge with increased LOS and in-hospital death.

AB - Multiple sclerosis (MS) is a chronic neuro-inflammatory disease of the central nervous system, associated with accumulation of irreversible neurological disabilities through both inflammatory relapses and progressive neurodegeneration. Patients with debilitating MS could benefit from palliative care perspectives both during relapses that lead to transient disability as well as later in the disease course when significant physical and cognitive disability have accrued. However, no data about palliative care utilization trends of MS patients are available. We examined 10-year temporal trends of palliative care and assessed independent associations of palliative care with hospital utilization and cost using the 2005–2014 national inpatient sample. The national trends of palliative care utilization in MS patients increased by 120 times from 0.2% to 6.1% during 2005–2014, particularly with the dramatic single-year increase between 2010 (1.5%) and 2011 (4.5%). Moreover, the proportion of receiving palliative care in in-hospital death gradually increased from 7.7% in 2005 to 58.8% in 2014. Palliative care in MS inpatients may affect hospital utilization and charges in different ways. Hospital palliative care was associated with increased length of stay (LOS) (β = 0.444 days, p < 0.001) and in-hospital death (OR = 15.35, 95% CI [13.76, 17.12]), but associated with decreased hospital charges (β = −$2261, p < 0.001). In conclusion, the temporal trends of palliative care use in MS inpatients gradually increased with an exponential increase between 2010 and 2011 during 2005–2014, which is mostly attributed to patients with higher risk of in-hospital death. Moreover, palliative care was associated with reduced hospital charge with increased LOS and in-hospital death.

UR - http://www.scopus.com/inward/record.url?scp=85055258510&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055258510&partnerID=8YFLogxK

U2 - 10.1016/j.jocn.2018.10.082

DO - 10.1016/j.jocn.2018.10.082

M3 - Article

C2 - 30454687

AN - SCOPUS:85055258510

VL - 58

SP - 13

EP - 19

JO - Journal of Clinical Neuroscience

JF - Journal of Clinical Neuroscience

SN - 0967-5868

ER -