Associations of Health Care Utilization and Therapeutic Alliance in Patients with Advanced Cancer.
- Resource Type
- Academic Journal
- Authors
- Bell SG; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Althouse AD; Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Belin SC; Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Arnold RM; Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Smith KJ; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; White DB; Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Chu E; Department of Oncology, Albert Einstein College of Medicine, Bronx, New York, USA.; Schenker Y; Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Thomas TH; Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
- Source
- Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 9808462 Publication Model: Print Cited Medium: Internet ISSN: 1557-7740 (Electronic) Linking ISSN: 15577740 NLM ISO Abbreviation: J Palliat Med Subsets: MEDLINE
- Subject
- Language
- English
Introduction: Therapeutic alliance (TA), or the extent to which patients feel a sense of caring and trust with their physician, may have an impact on health care utilization. We sought to determine if TA is associated with: (1) emergency department (ED) visits within 30 days of death and (2) hospice enrollment. Methods and Materials: This is a secondary analysis of data from a randomized clinical trial. We used restricted cubic splines to assess the relationship between TA scores and health care utilization. Results: Six hundred seventy-two patients were enrolled in the study, with 331 (49.3%) dying within 12 months. Patients with higher TA were less likely to have an ED visit in the last 30 days of life, but there was no evidence of a relationship between TA and enrollment in hospice. Conclusions: Higher TA was associated with decreased ED visits within 30 days of death. There was no association between TA and rates of hospice enrollment. Clinical Registration Number: NCT02712229.