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Abstract TMP7: Racial Differences In Palliative Care Utilization And Impact On Inpatient Mortality Length Stay And Costs Among Patients With Subarachnoid Hemorrhage


 Background and Purpose:
 Palliative is increasingly used in critically ill patients which has lead to shorter length of stays, higher inpatient mortality and lower utilization of aggressive treatment. We performed analysis to evaluate trends in utilization of palliative care among patients with subarachnoid hemorrhage and its effect on in-hospital outcomes over a 10-year period.
 
 
 Methods:
 We obtained data for patients admitted to hospitals in the United States from 2009 to 2018 with a primary diagnosis of subarachnoid hemorrhage (SAH) using a large national database. We determined the overall and sub racial rate of utilization of palliative care in patients with SAH and associated in-hospital outcomes consisting of mean hospital charges, mean length of stay and in-hospital mortality.
 
 
 Results:
 Out of 199928 patients admitted with primary diagnosis of SAH, palliative care was used in 20490 (10.2%). There was a 2.2-fold increase in utilization of PC (6.5%% in 2009 vs 14.4% in 2018; p<0.001). Similarly, there were 1.7, 2.9, 3.2- and 4.6-folds increase in utilization of PC among different races: whites, blacks, hispanics and others respectively, p<0.001. Overall rates of PC utilization among among different races: whites, blacks, hispanics and others were: 11.8%, 6.9%, 7.5% and 10.0%, p<0.001 respectively. The length of hospitalization remained significantly lower in patients undergoing PC compared with those who did not. (6.5±9.9 versus 11.6±12.6, p<0.001). The cost of hospitalization remained significantly lower in patients undergoing PC compared with those who did not. ($120526 ± 193412 versus $ 185116 ± 219434, p<0.001). Patients with PC utilization had significantly higher (72.7% versus 13.6%, p<0.001) in-hospital mortality compared ones with out.
 
 
 Conclusions:
 Between 2009 and 2018, there has been a significant increase in utilization of PC among patients with SAH along with shorter length of stay and lower hospital charges. SAH patients with PC had significantly higher in-hospital mortality.
