The following is a summary of “Functional Status Changes in Patients Receiving Palliative Care Consult During COVID-19 Pandemic,” published in the April 2023 issue of Pain Management by Xu, et al.

The COVID-19 pandemic has increased patient volume and acuity, raising concerns about access to palliative care for patients with functional impairment. The impact of the pandemic on functional status and hospital outcomes among patients receiving inpatient palliative care consultation was poorly understood. For a study, researchers sought to investigate changes in functional status and hospital outcomes among patients who received inpatient palliative care consultation before, during, and after the COVID-19 pandemic.

A retrospective, multisite cohort study included all adult patients (≥18 years) admitted to four hospitals in New York City, USA, and received inpatient palliative care consultation between March 1, 2019, and February 28, 2022. The patient’s functional status during consultation was measured using the Karnofsky Performance Status scale.

Among the 13,180 eligible patients identified, there was a decrease in functional status at the time of consultation as the volume of palliative care consultations increased during the pandemic. Two years after the pandemic, patients with noncancer and non-COVID-19 diagnoses showed a statistically significant trend of lower functional status (P < 0.001) and higher in-hospital mortality (P < 0.001) compared to the pre-pandemic period. In contrast, patients with cancer demonstrated a statistically significant trend of higher functional status (P < 0.001) and no significant changes in in-hospital mortality over time.

During the COVID-19 pandemic, the healthcare system faced significant strain with limited resources, leading to a prioritization of palliative care consultation for patients with lower functional status and higher in-hospital mortality. The shift disproportionately impacted noncancer patients. It was crucial to develop innovative approaches to ensure timely palliative care consultation for patients with functional impairment, especially during periods of increased resource constraints.

Source: jpsmjournal.com/article/S0885-3924(23)00467-0/fulltext