Emergency Departments Emerge As Key Entry Point For Hospice And Palliative Care

One-third of Americans will sojourn an emergency department, aliases ED, wrong a period of their death. While EDs are chiefly purposed to supply emergent care, they're progressively becoming an first touchpoint for hospice and palliative care, aliases HPC, referrals and consultations, according to a caller study from respective researchers astatine Henry Ford Health + Michigan State University Health Sciences.

The article, which will look successful nan November 2025 rumor of nan American Journal of Emergency Medicine, shares findings from nan largest study to day that evaluates hospice and palliative attraction consultations initiated successful nan ED. While some services attraction connected providing attraction to those facing superior illness, palliative attraction serves individuals sloppy of their aesculapian prognosis and hospice is reserved for individuals nearing nan extremity of their lives owed to terminal illness. This study evaluated 8,055 ED-initiated HPC consults astatine 5 Henry Ford Health EDs successful nan metro Detroit area from 2016 to 2023. Researchers evaluated and reported trends successful HPC consultations initiated successful nan ED. 

Among nan findings: 

• Palliative attraction accounted for 58% of each HPC consultations, highlighting a civilization displacement crossed a wellness strategy and emergency medicine whereby palliative attraction patients are much apt to person proactive objective appraisal and guidance initiated from nan ED. Historically, HPC needs were not addressed until patients were admitted to nan infirmary aliases discharged to community-based services. 
• During nan study's timeframe, hospice referrals decreased from 48.2% to 21.9%, whereas palliative attraction referrals accrued from 27.4% to 53.6%. 
• In nan 5 years since nan COVID-19 pandemic, HPC consultations successful EDs person accrued 173.6%, suggesting nan pandemic highlighted nan value of HPC successful nan ED. 

The summation successful consults pursuing nan pandemic underscores a heightened consciousness of palliative care's important role, peculiarly arsenic COVID-19 intensified nan request for end-of-life care."

Fabrice Mowbray, nan study's supervising writer and lead methodologist

Mowbray besides serves as director of nan Data Center astatine nan Michigan State University College of Nursing. 

The study besides noted anterior investigation showing palliative attraction teams successful U.S. hospitals expanding from 20% successful 2000 to 84% successful 2022 (for sites pinch astatine slightest 50 beds), demonstrating a taste displacement supra and beyond what was noted astatine HFH. 

"A increasing assemblage of lit supports these recommendations pinch grounds that expanding entree to hospice and palliative attraction consults successful some nan ED and inpatient settings tin amended goal-focused care, heighten diligent and family restitution and amended value of life during nan extremity shape of a patient's life," Mowbray said. 

He added that arsenic nan request for palliative attraction successful nan ED continues to rise, wellness attraction providers must proceed to supply policy, acquisition and investigation to heighten attraction for those pinch life-limiting illnesses. 

"Palliative care, arsenic a specialty, is comparatively caller successful nan United States, having only received general committee certification successful 2006," said Satheesh Gunaga, nan paper's lead writer and an emergency attraction expert astatine Henry Ford Health. "That is why investigation for illustration this is truthful important, truthful that we tin activity together to amended nan lives of immoderate of our astir susceptible patients." 

Additional researchers connected nan study see Abe Al-Hage, MSU College of Osteopathic Medicine and Henry Ford Health; Alyssa Buchheister, MSU College of Osteopathic Medicine and Henry Ford Health; Harish Neelam, MSU College of Human Medicine; Jessica Corcoran, MSU College of Osteopathic Medicine and Henry Ford Health; Michael Welchans, Henry Ford Health; Kirby Swan, MSU College of Osteopathic Medicine and Henry Ford Health; Mahmoud Awada, MSU College of Human Medicine; and Joseph Miller, MSU College of Human Medicine and Henry Ford Health.