{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:14:28Z","timestamp":1785161668390,"version":"3.55.0"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The 2022 ACC\/AHA\/HFSA guidelines recommend the integration of palliative care (PC) in heart failure (HF) management. The potential of telemedicine to improve PC utilization among HF patients remains an area of active research. However, the factors influencing its utilization remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study aimed to evaluate patient-level factors associated with tele-palliative care consultation (tele-PCC) utilization among HF patients admitted to a large health care system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cross-sectional observational analysis was conducted on 31,055 patients admitted to University of Pittsburgh Medical Center hospitals with HF between 2017 and 2022. Multivariable logistic regression was used to identify the predictors of tele-PCC utilization, and results are expressed as odds ratios (OR) and 95% confidence intervals (CI). The accuracy of the multivariate model was assessed using the area under the curve (AUC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients aged &lt;50 (OR: 15.12; 95% CI: 7.73\u201329.56;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and those with higher Charlson Comorbidity Index scores (OR: 1.130; 95% CI: 1.05\u20131.22;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002) were more likely to access tele-PCC. Patients with higher Area Deprivation Index (ADI) scores (ADI &lt;20 vs. (61\u201380) [OR]: 0.43; 95% CI: 0.18\u20130.99;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.048, ADI &lt;20 vs. &gt;80 [OR]: 0.40; 95% CI: 0.18\u20130.93;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.032), closer to a tertiary hospital (&lt;20 miles: OR: 0.21; 95% CI: 0.14\u20130.33;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), and those receiving care in the pre-COVID-19 era (OR: 0.06; 95% CI: 0.03\u20130.11;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) were less likely to utilize tele-PCC. No significant differences were observed based on gender, insurance type, or race. The multivariate model demonstrated strong predictive ability (AUC = 0.8996).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We observed greater tele-PCC utilization among younger patients and those with higher comorbidity burden and during the postpandemic era, while socioeconomic factors such as those with higher ADI continue to have limited access. These findings underscore the potential of telemedicine as a tool to enhance PC delivery to HF patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218251391007","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:33:27Z","timestamp":1762821207000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Determinants of Tele-Palliative Care Utilization Among Heart Failure Patients"],"prefix":"10.1177","author":[{"given":"Aleesha","family":"Kainat","sequence":"first","affiliation":[{"name":"Department of Internal Medine, University of Pittsburgh Medical Center, Mercy, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Very","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu","family":"Hurera","sequence":"additional","affiliation":[{"name":"Department of Internal Medine, University of Pittsburgh Medical Center, McKeesport, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhui","family":"Zhu","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Sezer","sequence":"additional","affiliation":[{"name":"Deutsche Bank, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floyd W.","family":"Thoma","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy","family":"Brinker","sequence":"additional","affiliation":[{"name":"Palliative &amp; Supportive Institute, University of Pittsburgh Medical Center, Mercy, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin W.","family":"Hickey","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1994"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.24035"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-024-01348-z"},{"key":"e_1_3_2_5_2","unstructured":"Anonymous. 2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology. n.d. 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