Background: Little is known about patient outcomes after discharge planning by inpatient palliative
care teams. A major difficulty is that successful discharge planning often effectively limits
or ends the team’s relationship with the patient and family. The goal of this study was to
gather a clearer picture of what happened to our palliative care consult patients after discharge.
Methods: This was a longitudinal survey of all patients seen over a one year period by the
inpatient palliative care team at Oregon Health & Science University (OHSU). Data were
recorded by team members at the time of consultation and supplemented by data from administrative
databases and death certificates.
Results: The team provided consults to 292 unique patients: 60% were younger than age 65,
39% were female, and 16% were members of an ethnic or racial minority. Almost three quarters
of patients carried a non-cancer diagnosis. Of the 292 patients, 37% died in hospital and
63% were discharged alive, either to home (54%), nursing facilities (20%), or inpatient hospice
(26%). Of the 183 patients discharged alive, 38% died within 2 weeks, 32% died between
2 weeks and 6 months, 25% were alive at 6 months, and 4% were unknown. Of note, only
10% of patients seen by the consult service were readmitted to OSHU within 30 days, and
only 5% of those discharged alive from OHSU ultimately died in an acute care hospital.
Discussion: We characterized patient outcomes following inpatient palliative care consultation:
where patients are discharged, how long they live, and where they die. Two thirds of
patients were able to be discharged, even when death occurred within two weeks. The low
rates of readmission and death in an acute care hospital support that the decision to discharge
the patients was reasonable and the discharge plan was adequate. Hospital based palliative
care teams can play an important and unique role in discharge planning—allowing even patients
very near death to leave the hospital if they wish.
