Race and birth country are associated with discharge location from hospital: A retrospective cohort study of demographic differences for patients receiving inpatient palliative care
Summary: Background: While past studies investigated access to palliative care among marginalized groups, few assessed whether there are differences in clinical process indicators based on demographics among those receiving palliative care. We aimed to: describe demographics among patients receivin...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-03-01
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| Series: | EClinicalMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022000335 |
| _version_ | 1818295547781447680 |
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| author | Sarina R. Isenberg Michael Bonares Allison M. Kurahashi Kavita Algu Ramona Mahtani |
| author_facet | Sarina R. Isenberg Michael Bonares Allison M. Kurahashi Kavita Algu Ramona Mahtani |
| author_sort | Sarina R. Isenberg |
| collection | DOAJ |
| description | Summary: Background: While past studies investigated access to palliative care among marginalized groups, few assessed whether there are differences in clinical process indicators based on demographics among those receiving palliative care. We aimed to: describe demographics among patients receiving inpatient palliative care; and evaluate whether demographic variables are associated with differences in disposition (i.e., discharge location), length of stay (LOS), and timing of inpatient palliative care referral and consultation. Methods: Retrospective cohort study using electronic medical record data to study patients seen by inpatient palliative care at Mount Sinai Hospital in Toronto, Canada between April 2018 to March 2019. Primary outcome was disposition. Secondary outcomes were LOS, time from admission to palliative referral, and time from referral to consultation. We summarized quantitative data descriptively and used fisher exact tests to explore relationships between categorial variables. For continuous outcomes, we ran one-way ANOVA tests. Findings: A total of 187 patients were referred to palliative care and met inclusion criteria. Mean age was 68·8 and 55·6% were female. 46·7% were born in Canada, 58·2% were White and 78·4% preferred English communication. Variables significantly associated with disposition were: birth country (p = 0·04), and race/ethnicity (p = 0·03). Language (F ratio = 3·6, p = 0·004) was significantly associated with time from admission to palliative care referral. No variables were associated with LOS or time from referral to consult. Interpretation: Inequalities in disposition, and how long it takes to refer to palliative care may exist. Further studies should focus on understanding the underlying practices that constructed, and maintained these inequalities in care. Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. |
| first_indexed | 2024-12-13T03:49:23Z |
| format | Article |
| id | doaj.art-323b6fc3f9e14f88a5dc98d84fc12911 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-13T03:49:23Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-323b6fc3f9e14f88a5dc98d84fc129112022-12-22T00:00:45ZengElsevierEClinicalMedicine2589-53702022-03-0145101303Race and birth country are associated with discharge location from hospital: A retrospective cohort study of demographic differences for patients receiving inpatient palliative careSarina R. Isenberg0Michael Bonares1Allison M. Kurahashi2Kavita Algu3Ramona Mahtani4Bruyère Research Institute, Ottawa, Ontario, Canada; Bruyère Research Institute, 43 Bruyère Street, Office 264J-G, Ottawa, Ontario K1N 5C8, Canada; Corresponding author at: Bruyère Research Institute, 43 Bruyère Street, Office 264J-G, Ottawa, Ontario K1N 5C8, CanadaDepartment of Medicine, University of Toronto, Toronto, Canada; Sunnybrook Health Sciences, Room H336, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, CanadaTemmy Latner Centre for Palliative Care, Sinai Health System, 60 Murray Street, 4th Floor Box 13, Toronto, Ontario, M5T 3L9, CanadaTemmy Latner Centre for Palliative Care, Sinai Health System, 60 Murray Street, 4th Floor Box 13, Toronto, Ontario, M5T 3L9, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, CanadaTemmy Latner Centre for Palliative Care, Sinai Health System, 60 Murray Street, 4th Floor Box 13, Toronto, Ontario, M5T 3L9, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, CanadaSummary: Background: While past studies investigated access to palliative care among marginalized groups, few assessed whether there are differences in clinical process indicators based on demographics among those receiving palliative care. We aimed to: describe demographics among patients receiving inpatient palliative care; and evaluate whether demographic variables are associated with differences in disposition (i.e., discharge location), length of stay (LOS), and timing of inpatient palliative care referral and consultation. Methods: Retrospective cohort study using electronic medical record data to study patients seen by inpatient palliative care at Mount Sinai Hospital in Toronto, Canada between April 2018 to March 2019. Primary outcome was disposition. Secondary outcomes were LOS, time from admission to palliative referral, and time from referral to consultation. We summarized quantitative data descriptively and used fisher exact tests to explore relationships between categorial variables. For continuous outcomes, we ran one-way ANOVA tests. Findings: A total of 187 patients were referred to palliative care and met inclusion criteria. Mean age was 68·8 and 55·6% were female. 46·7% were born in Canada, 58·2% were White and 78·4% preferred English communication. Variables significantly associated with disposition were: birth country (p = 0·04), and race/ethnicity (p = 0·03). Language (F ratio = 3·6, p = 0·004) was significantly associated with time from admission to palliative care referral. No variables were associated with LOS or time from referral to consult. Interpretation: Inequalities in disposition, and how long it takes to refer to palliative care may exist. Further studies should focus on understanding the underlying practices that constructed, and maintained these inequalities in care. Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.http://www.sciencedirect.com/science/article/pii/S2589537022000335Palliative careHealth equityRetrospective cohort studiesPatient dischargeLength of stay |
| spellingShingle | Sarina R. Isenberg Michael Bonares Allison M. Kurahashi Kavita Algu Ramona Mahtani Race and birth country are associated with discharge location from hospital: A retrospective cohort study of demographic differences for patients receiving inpatient palliative care EClinicalMedicine Palliative care Health equity Retrospective cohort studies Patient discharge Length of stay |
| title | Race and birth country are associated with discharge location from hospital: A retrospective cohort study of demographic differences for patients receiving inpatient palliative care |
| title_full | Race and birth country are associated with discharge location from hospital: A retrospective cohort study of demographic differences for patients receiving inpatient palliative care |
| title_fullStr | Race and birth country are associated with discharge location from hospital: A retrospective cohort study of demographic differences for patients receiving inpatient palliative care |
| title_full_unstemmed | Race and birth country are associated with discharge location from hospital: A retrospective cohort study of demographic differences for patients receiving inpatient palliative care |
| title_short | Race and birth country are associated with discharge location from hospital: A retrospective cohort study of demographic differences for patients receiving inpatient palliative care |
| title_sort | race and birth country are associated with discharge location from hospital a retrospective cohort study of demographic differences for patients receiving inpatient palliative care |
| topic | Palliative care Health equity Retrospective cohort studies Patient discharge Length of stay |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022000335 |
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