{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:57:57Z","timestamp":1780901877445,"version":"3.54.1"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P01AG066605"],"award-info":[{"award-number":["P01AG066605"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preadmission functional status has important predictive values for outcomes among hospitalized patients, and may facilitate healthcare resource allocation including early palliative care referral.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare acute healthcare and palliative care utilization among hospitalized patients with different levels of baseline functional impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of adult patients \u2265 18 years discharged from a quaternary academic hospital between July 1, 2022, and December 31, 2024, with baseline functional status assessed on admission via Karnofsky Performance Status (KPS) scale. Using electronic health records and billing data, we collected patients' socio\u2010demographic information, clinical characteristics, and utilization of acute healthcare and palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 18,049 patients, baseline functional impairment was classified as mild (KPS 70%\u2013100%): 13,411 (74.3%), moderate (KPS 50%\u201360%): 2953 (16.4%), severe (KPS30%\u201340%): 974 (5.4%) and very severe (KPS 10%\u201320%): 711 (3.9%). Overall, 2089 (11.6%) patients had a intensive care unit (ICU) admission, 1574 (8.7%) received palliative care consultation, and 1021 (5.6%) died in the hospital. In generalized linear models stratified by functional status category, increasing severity of functional impairment was significantly associated with increasing ICU admission, ICU and hospital length of stay, in\u2010hospital mortality, and receipt of palliative care intervention. Mean number of days between admission and palliative care consultation was significantly decreased among patients with very severe impairment when compared with those with mild impairment (5.3 vs. 6.7 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baseline functional status assessment may offer an easy\u2010to\u2010measure guide for timely inpatient palliative care intervention among patients at elevated risk for in\u2010hospital morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhm.70359","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:02:36Z","timestamp":1780898556000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute healthcare and palliative care utilization among hospitalized patients with different levels of functional impairment"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2849-727X","authenticated-orcid":false,"given":"Luyi","family":"Xu","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine New York University Grossman School of Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zeng","sequence":"additional","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Bollens\u2010Lund","sequence":"additional","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Singer","sequence":"additional","affiliation":[{"name":"Enterprise Data Reporting Mount Sinai Health System New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Chai","sequence":"additional","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sean Morrison","sequence":"additional","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York New York USA"},{"name":"Geriatric Research Education and Clinical Center James J. Peters VA Medical Center, Bronx New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura P.","family":"Gelfman","sequence":"additional","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York New York USA"},{"name":"Geriatric Research Education and Clinical Center James J. 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