Referrals in Focus: A Retrospective Study of Palliative Care Referrals from Rheumatology Providers at an Academic...

Background: People with rheumatic diseases suffer from serious complications of their illness, though little research is available on the utilization of palliative care (PC) for this population. Methods: We performed a retrospective chart review of patients referred to outpatient PC from a single academic rheumatology practice over five years and reviewed patients seen concurrently by rheumatology and PC in the inpatient setting over one year. Results: Of 18,441 patients seen in the outpatient rheumatology practice over five years, 11 (0.06%) patients were referred to PC by rheumatology providers. Of the 527 patients seen by inpatient rheumatology over a year period, 14 (3%) had rheumatic disease and were also seen by inpatient PC. Average time to death was 190 days among outpatients and 139 days among inpatients. Conclusion: Patients with rheumatic disease are rarely referred to PC despite high morbidity and mortality. Interventions are needed to improve this gap in care.