Associations of Health Care Utilization and Therapeutic Alliance in Patients with Advanced Cancer

Sarah G. Bell; Andrew D. Althouse; Shane C. Belin; Robert M. Arnold; Kenneth J. Smith; Douglas B. White; Edward Chu; Yael Schenker; Teresa H. Thomas

doi:10.1089/jpm.2023.0559

Associations of Health Care Utilization and Therapeutic Alliance in Patients with Advanced Cancer

Sarah G. Bell, Andrew D. Althouse, Shane C. Belin, Robert M. Arnold, Kenneth J. Smith, Douglas B. White, Edward Chu, Yael Schenker, Teresa H. Thomas

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Therapeutic alliance (TA), or the extent to which patients feel a sense of caring and trust with their physician, may have an impact on health care utilization. We sought to determine if TA is associated with: (1) emergency department (ED) visits within 30 days of death and (2) hospice enrollment. Methods and Materials: This is a secondary analysis of data from a randomized clinical trial. We used restricted cubic splines to assess the relationship between TA scores and health care utilization. Results: Six hundred seventy-two patients were enrolled in the study, with 331 (49.3%) dying within 12 months. Patients with higher TA were less likely to have an ED visit in the last 30 days of life, but there was no evidence of a relationship between TA and enrollment in hospice. Conclusions: Higher TA was associated with decreased ED visits within 30 days of death. There was no association between TA and rates of hospice enrollment. Clinical Registration Number: NCT02712229.

Original language	English (US)
Pages (from-to)	515-520
Number of pages	6
Journal	Journal of palliative medicine
Volume	27
Issue number	4
DOIs	https://doi.org/10.1089/jpm.2023.0559
State	Published - Apr 1 2024

Keywords

advanced cancer
emergency department visits
hospice enrollment
therapeutic alliance

ASJC Scopus subject areas

General Nursing
Anesthesiology and Pain Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1089/jpm.2023.0559

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title = "Associations of Health Care Utilization and Therapeutic Alliance in Patients with Advanced Cancer",

abstract = "Introduction: Therapeutic alliance (TA), or the extent to which patients feel a sense of caring and trust with their physician, may have an impact on health care utilization. We sought to determine if TA is associated with: (1) emergency department (ED) visits within 30 days of death and (2) hospice enrollment. Methods and Materials: This is a secondary analysis of data from a randomized clinical trial. We used restricted cubic splines to assess the relationship between TA scores and health care utilization. Results: Six hundred seventy-two patients were enrolled in the study, with 331 (49.3%) dying within 12 months. Patients with higher TA were less likely to have an ED visit in the last 30 days of life, but there was no evidence of a relationship between TA and enrollment in hospice. Conclusions: Higher TA was associated with decreased ED visits within 30 days of death. There was no association between TA and rates of hospice enrollment. Clinical Registration Number: NCT02712229.",

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AU - Bell, Sarah G.

AU - Althouse, Andrew D.

AU - Belin, Shane C.

AU - Arnold, Robert M.

AU - Smith, Kenneth J.

AU - White, Douglas B.

AU - Chu, Edward

AU - Schenker, Yael

AU - Thomas, Teresa H.

PY - 2024/4/1

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N2 - Introduction: Therapeutic alliance (TA), or the extent to which patients feel a sense of caring and trust with their physician, may have an impact on health care utilization. We sought to determine if TA is associated with: (1) emergency department (ED) visits within 30 days of death and (2) hospice enrollment. Methods and Materials: This is a secondary analysis of data from a randomized clinical trial. We used restricted cubic splines to assess the relationship between TA scores and health care utilization. Results: Six hundred seventy-two patients were enrolled in the study, with 331 (49.3%) dying within 12 months. Patients with higher TA were less likely to have an ED visit in the last 30 days of life, but there was no evidence of a relationship between TA and enrollment in hospice. Conclusions: Higher TA was associated with decreased ED visits within 30 days of death. There was no association between TA and rates of hospice enrollment. Clinical Registration Number: NCT02712229.

AB - Introduction: Therapeutic alliance (TA), or the extent to which patients feel a sense of caring and trust with their physician, may have an impact on health care utilization. We sought to determine if TA is associated with: (1) emergency department (ED) visits within 30 days of death and (2) hospice enrollment. Methods and Materials: This is a secondary analysis of data from a randomized clinical trial. We used restricted cubic splines to assess the relationship between TA scores and health care utilization. Results: Six hundred seventy-two patients were enrolled in the study, with 331 (49.3%) dying within 12 months. Patients with higher TA were less likely to have an ED visit in the last 30 days of life, but there was no evidence of a relationship between TA and enrollment in hospice. Conclusions: Higher TA was associated with decreased ED visits within 30 days of death. There was no association between TA and rates of hospice enrollment. Clinical Registration Number: NCT02712229.

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Associations of Health Care Utilization and Therapeutic Alliance in Patients with Advanced Cancer

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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