Authors:
Susan C Miller, Julie C Lima, Orna Intrator, Edward Martin, Janet Bull, Laura C Hanson

Executive Summary:

Tuesday Health embraces the findings of a research article led by Susan C Miller et al., shedding light on the positive impact of palliative care consultations in nursing homes. The study, a retrospective cohort analysis spanning 2006 to 2010, evaluated the association between the receipt and timing of palliative care consultations and end-of-life care transitions, with a focus on acute care use.

The research, conducted in forty-six nursing homes across two states, underscores the pivotal role of palliative care expertise, primarily delivered by nurse practitioners. The evaluation stratified nursing home residents based on the days between the initial consultation and death (≤7, 8-30, 31-60, 61-180) and employed propensity score matching for a robust retrospective cohort study.

Key Findings:

1. Reduced Hospitalization Rates: Residents who received palliative care consultations exhibited lower rates of hospitalization compared to controls. Notably, the lowest rates were observed when initial consultations occurred further from the time of death.

2. Optimal Timing for Consultations: Residents with initial consultations 8 to 30 days before death demonstrated a significantly lower adjusted hospitalization rate in the last 7 days of life (11.1%) compared to controls (22.0%). Even more striking, those with initial consultations 61 to 180 days before death showed a rate of 6.9%, emphasizing the potential benefits of early intervention.

3. Mitigation of Potentially Burdensome Transitions: Palliative care consultations, especially when initiated 61 to 180 days before death, contributed to lower rates of potentially burdensome care transitions. The study defines these transitions as hospitalization or hospice admission within 3 days of death or two or more hospitalizations or ED visits within 30 days.

Conclusion:

The research unequivocally demonstrates that palliative care consultations in nursing homes lead to improved end-of-life care. By effectively reducing hospitalization rates and mitigating potentially burdensome care transitions, palliative care interventions, particularly when initiated well in advance, contribute to a more compassionate and tailored approach to end-of-life care in nursing home settings.

This aligns with Tuesday Health’s commitment to transforming supportive and end-of-life care through clinical expertise, data-driven solutions, and a patient-centric approach. As we continue to evolve our programs, this research reinforces the importance of proactive palliative care interventions in enhancing the well-being of individuals facing serious illnesses in nursing homes.