National trends in palliative care use among older adults with cardiopulmonary and malignant conditions

Abstract

BackgroundPalliative care consultation (PCC) is recommended for older adults hospitalized with cardiopulmonary conditions, but frequently is reserved for patients with malignant conditions and those with advanced age. ObjectivesTo compare age-adjusted PCC trends and the relationship between increasing age and PCC among older adults with cardiopulmonary and malignant conditions. MethodsObservational analysis of patients age ≥ 65 years, stratified by age and cardiopulmonary (heart failure, chronic obstructive pulmonary disease) vs. malignant (lung and gastrointestinal) conditions. Age-adjusted PCC trends over time and compound annual growth rates (CAGR) were compared. ResultsDischarges with cardiopulmonary vs. malignant conditions were older, more likely to be female, and white. Relative to malignant conditions, discharges with cardiopulmonary conditions had lower age-adjusted PCC rates but higher CAGRS. Increasing age was associated with PCC in both groups but had a stronger effect among cardiopulmonary conditions. ConclusionsOlder adults with cardiopulmonary conditions experienced lower rates of PCC, but higher rates of growth over time relative to those with malignant conditions.