{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T14:20:39Z","timestamp":1788272439984,"version":"build-2803163510"},"reference-count":40,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>End-stage liver disease (ESLD) patients carry heavy symptom burdens and risk receiving aggressive and sometimes unwanted care at end of life. Palliative care (PC), which aims to alleviate symptoms and facilitate goal-concordant care in serious illness, may offer substantial benefits for ESLD patients but is not widely provided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess the impact of PC integrated within hepatology (PCIH) services on health care utilization, advance care planning (ACP), and hospice enrollment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>\n                      We compared patients who received PCIH (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200955) to a retrospective cohort (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200957) receiving usual care in an outpatient hepatology clinic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Subjects:<\/jats:title>\n                    <jats:p>From June 2016 to November 2017, we enrolled patients receiving care in a U.S. public hospital clinic who met the following inclusion criteria: (1) ESLD with a Model for End-Stage Liver Disease score \u226520, (2) hepatology approval for PC referral, and (3) at least one advanced complication of ESLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>We assessed patient demographics, clinical information, health care insurance status, health care utilization, completion of psychosocial assessments, and ACP using two-sided Fisher's exact test and Mann\u2013Whitney U tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients receiving PCIH more frequently had goals of care discussions (87.3% vs. 21.2%\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009\u2264\u20090.01), completed ACP documentation (56.4% vs. 7.0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009\u2264\u20090.01), psychosocial assessments (98.2% vs. 35.1%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009\u2264\u20090.01), and hospice enrollment (25.5% vs. 7.0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01). Patients receiving PCIH who were hospitalized also had fewer mean hospitalization days (13 vs. 19.7 days,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009\u2264\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Embedding PC services in a hepatology clinic is a promising strategy to improve care for ESLD patients in public hospitals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jpm.2022.0438","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T14:54:01Z","timestamp":1672239241000},"page":"776-783","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["A Pilot Study of a Palliative Care Service Embedded in a Hepatology Clinic at a Large Public Hospital"],"prefix":"10.1177","volume":"26","author":[{"given":"Carin","family":"van Zyl","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Geriatric, Hospital, Palliative, and General Internal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA."},{"name":"Department of Medicine, Los Angeles County + University of Southern California Medical Center, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron D.","family":"Storms","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Geriatric, Hospital, Palliative, and General Internal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA."},{"name":"Department of Medicine, Los Angeles County + University of Southern California Medical Center, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Welmoed","family":"van Deen","sequence":"additional","affiliation":[{"name":"Gehr Family Center for Health Systems Science, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA."},{"name":"Erasmus School of Health Policy and Management, Health Technology Assessment Section, Erasmus University Rotterdam, Rotterdam, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0116-9038","authenticated-orcid":false,"given":"Valeria","family":"Cardenas","sequence":"additional","affiliation":[{"name":"Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Los Angeles County + University of Southern California Medical Center, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Flores","sequence":"additional","affiliation":[{"name":"Department of Medicine, Los Angeles County + University of Southern California Medical Center, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Donovan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Los Angeles County + University of Southern California Medical Center, Los Angeles, California, USA."},{"name":"Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily","family":"Chu","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanu","family":"Patel","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Enguidanos","sequence":"additional","affiliation":[{"name":"Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,2]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.03956.x"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2000.tb03121.x"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2005.01.020"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.10.016"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.08.027"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2012.11.002"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32378"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2011.07.028"},{"key":"e_1_3_5_10_2","unstructured":"Center for Medicare and Medicaid. Hospice-Liver Disease. Medicare Coverage Database. January 2022. Available from: https:\/\/www.cms.gov\/medicare-coverage-database\/view\/lcd.aspx?LCDId=34544 [Last accessed: February 22 2022]."},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.03.022"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318277f238"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnur.2010.03.005"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.290"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.07.014"},{"key":"e_1_3_5_16_2","unstructured":"Walling AM Wenger N. Palliative care for patients with end-stage liver disease. January 2022. Available from: https:\/\/www.uptodate.com\/contents\/palliative-care-for-patients-with-end-stage-liver-disease [Last accessed: February 22 2022]."},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.5500\/wjt.v6.i3.594"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2013.0167"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016887"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29297"},{"key":"e_1_3_5_21_2","unstructured":"POLST California. Coalition for Compassionate Care of California. 2022. https:\/\/capolst.org [Last accessed: February 22 2022]."},{"key":"e_1_3_5_22_2","unstructured":"CA.gov. Vital Records Data and Statistics. 2020. Available from: https:\/\/www.cdph.ca.gov\/Programs\/CHSI\/Pages\/Data-and-Statistics-.aspx [Last accessed: July 11 2022]."},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31226"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.03.013"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.314"},{"issue":"2","key":"e_1_3_5_26_2","first-page":"406","article-title":"EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis [published correction appears in J Hepatol. 2018 Nov;69(5):1207]","volume":"69","author":"European Association for the Study of the Liver","year":"2018","unstructured":"European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis [published correction appears in J Hepatol. 2018 Nov;69(5):1207]. J Hepatol, 2018; 69(2):406\u2013460; doi: 10.1016\/j.jhep.2018.03.024","journal-title":"J Hepatol"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2005.8.576"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2014.0184"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.8870"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01045.x"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.14.1665"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12105"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa0907901"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.16430"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.24727"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2016.0002"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2011.10.018"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216318756222"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.7326\/M15-0071"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2010.07.004"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2019.0121"}],"container-title":["Journal of Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jpm.2022.0438","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jpm.2022.0438","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jpm.2022.0438","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:17:00Z","timestamp":1777655820000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jpm.2022.0438"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":40,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1089\/jpm.2022.0438"],"URL":"https:\/\/doi.org\/10.1089\/jpm.2022.0438","relation":{},"ISSN":["1096-6218","1557-7740"],"issn-type":[{"value":"1096-6218","type":"print"},{"value":"1557-7740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}