Home palliative care needs are often under-recognized in patients with End-Stage Renal Disease (ESRD). This pilot study is designed to evaluate the feasibility and acceptability of an initiative to enhance referrals to Penn Home Palliative Care compared with usual care among hemodialysis-dependent ESRD patients admitted to a Penn hospital. Results will inform a future pragmatic trial comparing the effectiveness of home palliative care compared with usual care among ESRD patients. Evaluating the effectiveness of home palliative care services is critical to determine whether increasing access to these services would improve patient-centered outcomes for these high-need patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
285
The case manager and covering providers for inpatients who have been identified according to the study's inclusion criteria as appropriate for Penn Home Palliative Care (PHPC) upon hospital discharge will be asked to refer their patient for these home palliative care services.
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Rate of Home Palliative Care Receipt
Receipt of home palliative care will be defined as at least one home palliative care visit within 45 days after hospital discharge, determined via electronic health record review.
Time frame: Baseline - 45 days
Follow-up Home Palliative Care Visits
The total number of home palliative care visits during the 180-day follow-up period after hospital discharge will be assessed using the electronic health record.
Time frame: Baseline - 180 days
Mortality
Mortality rates will be assessed using the electronic health record after the 180-day follow-up period.
Time frame: Baseline - 180 days
Hospital-free days
The number of hospital-free days during the 180-day follow-up period will be assessed using the electronic health record and administrative data for the tri-state area.
Time frame: Baseline - 180 days
Acceptability of home palliative care referral among clinician stakeholders
Acceptability of home palliative care referral among clinician stakeholders will be measured via survey and focus group questions.
Time frame: Baseline - 180 days
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