The Effects of the Palliative Medicine Consultation on the DNR Status of African Americans in a Safety-Net Hospital. (June 2013)

• Record Type: Journal Article
• Authors: Sacco, Joseph; Carr, Dana R. Deravin; Viola, Deborah
• Is Part Of: American journal of hospice & palliative care. Volume 30:Number 4(2013)
• Page Start: 363
• Page End: 369
• Publication Date: 2013-06
• Subjects: advanced directives -- do not resusitate -- disparities -- palliative medicine -- consultation -- hospice -- barriers; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/1049909112450941
• Languages: English
• ISSNs: 1049-9091

Abstract

Objective: 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.