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Adding Functional Ability Measures to a Mortality Algorithm to Support Palliative Care Eligibility Decisions.

Elizabeth A Luth1,2, Carlin Brickner3, Harivony Rakotoarivelo3

  • 1Department of Family and Community Medicine, Robert Wood Johnson Medical School.

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Summary
This summary is machine-generated.

Functional ability measures like activities of daily living (ADL) support and skilled nursing predict mortality. Physical therapy/occupational therapy (PT/OT) services were linked to lower mortality, aiding palliative care referrals.

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Area of Science:

  • Gerontology
  • Health Services Research
  • Palliative Care

Background:

  • Identifying individuals for palliative care is crucial for improving quality of life.
  • Administrative claims data offer a valuable resource for assessing patient functional status.
  • Functional ability measures can serve as indicators for serious illness and mortality risk.

Purpose of the Study:

  • To establish functional ability measures from administrative claims data.
  • To identify patients eligible for palliative care.
  • To analyze the relationship between functional ability and mortality.

Main Methods:

  • Retrospective cohort analysis of Medicare Advantage claims data (July 2022-June 2023).
  • Inclusion of 6,625 enrollees.
  • Logistic regression to assess associations between functional ability measures (ADL, feeding/respiratory support, PT/OT, skilled nursing) and mortality.

Main Results:

  • 186 (4.6%) deaths occurred during the study period.
  • Physical therapy/occupational therapy (PT/OT) services were associated with decreased mortality (aOR=0.74, 95% CI [0.65, 0.85]).
  • Activities of daily living (ADL) support, skilled nursing, and pain management were linked to increased mortality.

Conclusions:

  • Functional ability measures derived from claims data can predict mortality risk.
  • Observing PT/OT, ADL support, and skilled nursing status may facilitate timely palliative care referrals.
  • These findings support the use of administrative data for proactive patient management in serious illness.