Home palliative care needs are often under-recognized in patients with End-Stage Renal Disease (ESRD). This pilot study is designed to evaluate the effectiveness of referrals to home palliative care services in improving patient outcomes compared with usual care among patients with ESRD admitted to a Penn hospital. 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
315
The attending and covering providers for inpatients who have been identified according to the study's inclusion criteria as appropriate for home palliative care services upon hospital discharge will be asked to refer their patient for these services.
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Acute Encounters
A combined count of hospitalizations, Emergency Department, and Observation visits during the 180-day follow-up period that will be assessed using the electronic health record and administrative data for the tri-state area
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
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
Time to Home Palliative Care Visit
Days from hospital discharge to the first home palliative care visit.
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
Hospice Enrollment
New hospice enrollment will be assessed using the electronic health record and administrative data for the tristate area.
Time frame: Baseline - 180 days
Health-Related Quality of Life
Health-related quality of life will be assessed by the EQ-5D survey of patients at 1- and 3-months post-hospital discharge time-points.
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Time frame: 1- and 3-months
Symptom Burden
Symptom burden will be assessed by the Edmonton Symptom Assessment System survey of patients at 1- and 3-months post-hospital discharge time-points.
Time frame: 1- and 3-months
Quality of Care
Quality of care will be assessed by the CMS-MACRA PC Quality Measures (Received Help for Pain; Felt Heard \& Understood) for patients at 1- and 3-months post-hospital discharge time-points.
Time frame: 1- and 3-months