Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Utilization of Palliative Care in Veterans Admitted With Heart Failure Experiencing Homelessness.

Gula AL, Ramos J, Simpson JM, Jiang L, Martin E, Wice M, Erqou S, Wu WC, Rudolph JL. Utilization of Palliative Care in Veterans Admitted With Heart Failure Experiencing Homelessness. Journal of pain and symptom management. 2022 Nov 1; 64(5):471-477.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions



Abstract:

CONTEXT: Patients experiencing housing insecurity have numerous barriers affecting their utilization of medical care. OBJECTIVES: Determine if housing insecurity is associated with palliative care (PC) encounters and hospice services in patients with heart failure who receive care in United States Veterans Affairs (VA) medical centers. METHODS: This retrospective study included inpatients in VA hospitals with a primary diagnosis of congestive heart failure from 2010 to 2020. Housing stability was collected from coding and separated into three cohorts: at risk for homelessness, experiencing homelessness, and stably housed. The primary outcome was a PC encounter during admission and the stably housed cohort was used as the analytic reference. Inverse-probability-weighting (IPTW) was calculated to adjust the likelihood of receiving PC during the index admission. RESULTS: Seventy thousand eight hundred fourty nine veterans were identified. Veterans were identified as at risk for homelessness (n = 4039, 5.7%), experiencing homelessness (n = 1967, 2.8%) and stably housed (n = 64,843, 91.5%). PC was delivered to veterans at risk for homelessness (n = 484, 12.0%), veterans experiencing homelessness, (n = 161, 8.2%) and patients with stable housing (n = 6249, 9.6%). Relative to the stably housed and adjusted for IPTW, those at risk for homelessness received PC services similarly (adjusted OR = 1.06, 95% CI 0.94,1.19) and those experiencing homelessness were at lower odds of receiving PC services (adjusted OR = 0.62, 95% CI 0.52,0.75). CONCLUSION: Housing stability may be a factor in Veterans receiving PC during hospitalization for heart failure. While the logistical challenges of delivering PC and hospice to people experiencing homelessness are daunting, advocating for these services shows commitment to reducing suffering in life-limiting Illness.





Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.