Utilization of Palliative Care Screening Tool to Early Identify Patients with COVID-19 Needing Palliative Care: A Cohort Study

Yung-Feng Yen, Hsiao-Yun Hu, Yi-Chang Chou, Chu-Chieh Chen and Chin-Yu Ho
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Yung-Feng Yen: Section of Infectious Diseases, Taipei City Hospital, Yangming Branch, Taipei 112, Taiwan
Hsiao-Yun Hu: Institute of Public Health, National Yang-Ming Chiao Tung University, Taipei 112, Taiwan
Yi-Chang Chou: Department of Education and Research, Taipei City Hospital, Taipei 106, Taiwan
Chu-Chieh Chen: Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
Chin-Yu Ho: School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan

IJERPH, 2022, vol. 19, issue 3, 1-8

Abstract: There are very few programs that identify patients with coronavirus disease 2019 (COVID-19) who need palliative care. This cohort study presents a model to use a validated palliative care screening tool (PCST) to systematically identify hospitalized patients with COVID-19 in need of palliative care. In this prospective study, we consecutively recruited patients with COVID-19 admitted to Taipei City Hospital between 1 January and 30 July 2021. Patients’ palliative care needs were determined by using the PCST. Advance care planning (ACP) and advance directives (AD) were systemically provided for all patients with a PCST score ≥ 4. Of 897 patients, 6.1% had a PCST score ≥ 4. During the follow-up period, 106 patients died: 75 (8.9%) with a PCST score < 4 and 31 (56.4%) with a PCST score ≥ 4. The incidence of mortality was 2.08 and 0.58/100 person-days in patients with PCST scores ≥ 4 and <4, respectively. After controlling for other covariates, a PCST score ≥ 4 was associated with a higher risk of mortality in patients with COVID-19 (adjusted HR = 2.08; 95% CI: 1.22–3.54; p < 0.001). During hospitalization, 55 patients completed an ACP discussion with their physicians, which led to 15 of them completing the AD. Since hospitalized patients with COVID-19 had a high mortality rate, it is imperative to implement a comprehensive palliative care program to early identify patients needing palliative care and promotion of AD and ACP.

Keywords: palliative care program; palliative care screening tool; COVID-19; advance directive; advance care planning; prospective study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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