부산대학교 도서관

1. Identify and understand the benefits of a concurrent hospice dialysis program in providing opportunities for patients to choose quality care near the end of life 2. The learner will comprehend the goals for future directions for the concurrent hospice dialysis program and implementation of the program in diverse settings Patients on dialysis are less likely to access timely end-of-life services mainly because of financial restrictions in the Medicare Hospice Benefit. Through a partnership between nonprofit dialysis hospice and dialysis organizations, we developed a concurrent hospice and dialysis program in which patients may receive limited palliative dialysis alongside hospice services. The goal of this program is to improve access to high-quality end-of-life care and ultimately improve the experience for patients, care partners, and clinicians. To describe a concurrent hospice dialysis program's participants, dialysis utilization, and hospice outcomes. We collected demographics, patient characteristics, and utilization data from the medical records of patients enrolled in the concurrent program. Between 2018 and 2021, 39 participants enrolled in the program; 48% were female and 70% were over 70 years of age. 48% of participants received at least 1 dialysis treatment, and 52% received no dialysis. The average hospice length of stay was 12.1 days (1-76) for all participants and 16.3 days (5-36) for those who received at least 1 dialysis treatment. The average number of hemodialysis treatments was 3.8 (1-9). 66% died at home, 20% died in inpatient hospice, and 13% died in a nursing facility. Our 3-year experience with a concurrent program demonstrated that patients had on average longer length of stay on hospice compared to the national average of 7 days. Although patients elected the program with the expectation of continuing palliative dialysis, only half received at least 1 dialysis treatment. Our experience suggests that a concurrent hospice and dialysis program provides patients with a psychological bridge by allowing patients to receive hospice and continue dialysis. Future work will test the effectiveness of such clinical programs to improve patient and utilization outcomes. [ABSTRACT FROM AUTHOR]