Study Finds Delayed Use of LTACH’s Palliative Care Consult Service

The average time between admission to a long-term acute care floor at a transitional care hospital and a consult with palliative care was more than 7 months, according to study findings.

Studies suggest that “nearly half of patients die within the first year of [long-term acute care hospital, or LTACH] admission; however, palliative care teams are consulted for 1% of patients in LTACHs,” explained a team of authors from Eastern Virginia Medical School and Lake Taylor Transitional Care Hospital. “Establishing goals of care can improve quality of life, fulfill patients’ wishes, and decrease health care costs.”

In January 2018, Lake Taylor Transitional Care Hospital launched a palliative medicine consult service to address the needs of patients with chronic critically illness. The study gauged use of the service between February 2019 and October 2021.

On the hospital’s long-term acute care floors, 132 patients received palliative care consults during the study period. The majority were male (61.4%) and Black or African American (64.4%); their mean age was 62.82 years, researchers reported.

After admission, an average 230.34 days passed before palliative care was consulted, the study showed. Devices and procedures most commonly addressed were tracheostomy (98.4%), percutaneous endoscopic gastrostomy (PEG)/feeding tube (95.2%), ventilator (85.7%), and dialysis (20.6%).

“Average time from admission to consult was 230 days, seemingly long for a critically ill population whose survival is 6.7 months,” researchers wrote. “Shorter time to consults could improve patient comfort, goals of care, and health care usage.”

Reference:
Goel R, Benz C, Galicia-Castillo M. Palliative care needs within LTACH (GP755). J Pain Symptom Manage. 2022;63(6):1142-1143. doi:10.1016/j.jpainsymman.2022.04.146