Hospitals Vary Widely in Moving Stroke Patients to Comfort Care

Doctors more apt to suggest it sooner for older, white, female, and uninsured patients

elderly hospital patient

THURSDAY, May 25, 2017 (HealthDay News) -- U.S. hospitals differ greatly in how often they move new stroke patients from treatment to comfort or hospice care, according to a study published online May 24 in Neurology: Clinical Practice.

Shyam Prabhakaran, M.D., a professor of neurology and medical social sciences at the Northwestern University Feinberg School of Medicine in Chicago, and colleagues analyzed data from 963,525 patients treated for stroke in 1,675 hospitals between 2009 and 2013. The authors note that 54,794 had doctor's orders for comfort care only.

Overall, 5.6 percent of the patients were moved to comfort care only. However, the researchers found that the rate varied widely among hospitals, from 0.6 to 37.6 percent. The percentage of patients who were moved to early comfort care fell over the four-year study period, from 6.1 to 5.4 percent. Patients with hemorrhage strokes were more likely to be moved sooner to comfort care than those with ischemic strokes. Patients who were older, female, white, unable to walk, and uninsured or covered by Medicaid were also more likely to have early comfort orders, as were those who arrived at the hospital during off-hours or by ambulance.

"The use of early comfort care varies widely between hospitals and is influenced by stroke type as well as the characteristics of both the hospitals and the people who are hospitalized," Prabhakaran said in a journal news release. More study is needed to learn how such decisions are made, he added.

Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Physician's Briefing