Factors Associated with Access to Palliative Care in a Large Urban Public Teaching Hospital with a Formal Hospital-Based Palliative Care Program

摘要: FACTORS ASSOCIATED WITH ACCESS TO PALLIATIVE CARE IN A LARGE URBAN PUBLIC TEACHING HOSPITAL FORMAL HOSPITAL-BASED PROGRAM By Leland Hubert Waters III, Ph.D. M.S. dissertation submitted in partial fulfillment of the requirements for degree Doctor Philosophy Health Related Sciences at Virginia Commonwealth University. University, 2012 Major Director: J. James Cotter, Hospital-based specialist palliative care services are designed to address needs critically ill patients by psychosocial and spiritual support, improving symptoms management, offering discussions on goals care. Integrating upstream continuum who eventually die hospital will help many individualistic patient. The diffusion hospital-based requires an understanding patterns utilization patients. purpose this study was examine population characteristics decedents may or not have utilized a setting order develop model predictors access services. basic constructs grounded Behavioral Model Services Use. Potential is measured terms characteristics, which include predisposing enabling resources, evaluated need. Building theoretical model, sought better understand equitable inequitable specialized define realized were dominant. research question asked was: What within large urban public teaching hospital? consult predictor unit explored. Findings from revealed that factors encouraging older age, White non-Hispanic ethnic membership, diagnosis with solid cancer insurance. Factors gender (female), insurance, either hematologic malignancy diagnosis.