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The effects of the Palliative Medicine Consultation on the DNR status of African Americans in a safety-net hospital

TitleThe effects of the Palliative Medicine Consultation on the DNR status of African Americans in a safety-net hospital
Publication TypeJournal Article
Year of Publication2013
AuthorsSacco, J, Carr, DRDeravin, Viola, D
JournalAm J Hosp Palliat CareAm J Hosp Palliat Care
Volume30
Pagination363-9
Date PublishedJun
ISBN Number1938-2715 (Electronic)<br/>1049-9091 (Linking)
Accession Number22777405
KeywordsAdvance Directives/ ethnology/statistics & numerical data, African Americans/ statistics & numerical data, Aged, Communication, Critical Illness, data, Female, Health Knowledge, Attitudes, Practice/ethnology, Hispanic Americans/ statistics & numerical data, Humans, Male, Middle Aged, New York City, Palliative Care/methods/ organization & administration/statistics & numerical, Poverty Areas, Prognosis, Referral and Consultation/statistics & numerical data, Resuscitation Orders, Retrospective Studies
AbstractOBJECTIVE: To examine the effectiveness of palliative medicine consultation on completion of advance directives/do-not-resuscitate (DNR) orders by racial/ethnic minorities. METHOD: A sample of 1999 seriously ill African American and Hispanic inpatients was obtained from the Palliative Medicine Consultation database (n = 2972). Associations between race/ethnicity and diagnosis and documentation of DNR status on admission and discharge were examined. RESULTS: Cancer was the primary diagnosis, 34.5%. Among patients with a consultation, 98% agreed to discuss advance directives; 65% of African Americans and 70% of Hispanics elected DNR status. Inpatient deaths were 46%; 74% of decedents agreed to DNR orders. Discharged patients referred to hospice were 29%. CONCLUSION: Palliative medicine consultations resulted in timely completion of DNR orders and were positively associated with DNR election and hospice enrollment.
Ethno Med: