{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T18:11:37Z","timestamp":1789236697862,"version":"build-2803163510"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National Institutes of Health (NIH) Health Care Systems Research Collaboratory","award":["UG3\/UH3 AT009844"],"award-info":[{"award-number":["UG3\/UH3 AT009844"]}]},{"name":"National Institutes of Health (NIH) Health Care Systems Research Collaboratory","award":["UG3\/UH3 AT009844"],"award-info":[{"award-number":["UG3\/UH3 AT009844"]}]},{"name":"National Institutes of Health (NIH) Health Care Systems Research Collaboratory","award":["UG3\/UH3 AT009844"],"award-info":[{"award-number":["UG3\/UH3 AT009844"]}]},{"name":"National Institutes of Health (NIH) Health Care Systems Research Collaboratory","award":["UG3\/UH3 AT009844"],"award-info":[{"award-number":["UG3\/UH3 AT009844"]}]},{"name":"National Institutes of Health (NIH) Health Care Systems Research Collaboratory","award":["UG3\/UH3 AT009844"],"award-info":[{"award-number":["UG3\/UH3 AT009844"]}]},{"name":"NIH National Center for Complementary and Integrative Health Administrative Supplement for Complementary Health Practitioner Research Experience","award":["UH3 AT009844"],"award-info":[{"award-number":["UH3 AT009844"]}]},{"name":"NIH National Center for Complementary and Integrative Health Administrative Supplement for Complementary Health Practitioner Research Experience","award":["UH3 AT009844"],"award-info":[{"award-number":["UH3 AT009844"]}]},{"name":"NIH National Center for Complementary and Integrative Health Administrative Supplement for Complementary Health Practitioner Research Experience","award":["UH3 AT009844"],"award-info":[{"award-number":["UH3 AT009844"]}]},{"name":"NIH National Center for Complementary and Integrative Health Administrative Supplement for Complementary Health Practitioner Research Experience","award":["UH3 AT009844"],"award-info":[{"award-number":["UH3 AT009844"]}]},{"name":"NIH National Center for Complementary and Integrative Health Administrative Supplement for Complementary Health Practitioner Research Experience","award":["UH3 AT009844"],"award-info":[{"award-number":["UH3 AT009844"]}]},{"name":"NIH Collaboratory Coordinating Center","award":["U24AT009676"],"award-info":[{"award-number":["U24AT009676"]}]},{"name":"NIH Collaboratory Coordinating Center","award":["U24AT009676"],"award-info":[{"award-number":["U24AT009676"]}]},{"name":"NIH Collaboratory Coordinating Center","award":["U24AT009676"],"award-info":[{"award-number":["U24AT009676"]}]},{"name":"NIH Collaboratory Coordinating Center","award":["U24AT009676"],"award-info":[{"award-number":["U24AT009676"]}]},{"name":"NIH Collaboratory Coordinating Center","award":["U24AT009676"],"award-info":[{"award-number":["U24AT009676"]}]},{"name":"National Center for Complementary and Integrative Health of the National Institutes of Health","award":["UH3AT009844"],"award-info":[{"award-number":["UH3AT009844"]}]},{"name":"National Center for Complementary and Integrative Health of the National Institutes of Health","award":["UH3AT009844"],"award-info":[{"award-number":["UH3AT009844"]}]},{"name":"National Center for Complementary and Integrative Health of the National Institutes of Health","award":["UH3AT009844"],"award-info":[{"award-number":["UH3AT009844"]}]},{"name":"National Center for Complementary and Integrative Health of the National Institutes of Health","award":["UH3AT009844"],"award-info":[{"award-number":["UH3AT009844"]}]},{"name":"National Center for Complementary and Integrative Health of the National Institutes of Health","award":["UH3AT009844"],"award-info":[{"award-number":["UH3AT009844"]}]},{"name":"atient-Centered Outcomes Research Institute (PCORI) award","award":["PLC-1609\u201336,306"],"award-info":[{"award-number":["PLC-1609\u201336,306"]}]},{"name":"atient-Centered Outcomes Research Institute (PCORI) award","award":["PLC-1609\u201336,306"],"award-info":[{"award-number":["PLC-1609\u201336,306"]}]},{"name":"atient-Centered Outcomes Research Institute (PCORI) award","award":["PLC-1609\u201336,306"],"award-info":[{"award-number":["PLC-1609\u201336,306"]}]},{"name":"atient-Centered Outcomes Research Institute (PCORI) award","award":["PLC-1609\u201336,306"],"award-info":[{"award-number":["PLC-1609\u201336,306"]}]},{"name":"atient-Centered Outcomes Research Institute (PCORI) award","award":["PLC-1609\u201336,306"],"award-info":[{"award-number":["PLC-1609\u201336,306"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Healthy Days at Home (HDaH) is a patient-centered outcome measure quantifying the number of days individuals spend at home without hospitalizations or emergency department (ED) visits, while maintaining functional independence. This study examines the association between HDaH and prognosis among US older adults with serious life-limiting illnesses (commonly heart failure, chronic obstructive pulmonary disease, advanced cancer, and end-stage kidney disease) and explores how this relationship differs by cancer status.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>For this prospective cohort design study, we pooled Medicare Claims data of older adults (aged 66 or greater) with serious life-limiting illnesses who visited one of 30 EDs participating in the Primary Palliative Care for Emergency Medicine study between 2015 and 2019. The main exposure was prognosis, measured using the Gagne index, a short-term predictor of mortality. We controlled for age, sex, race\/ethnicity, and used cancer diagnosis as a secondary predictor and stratification variable. The outcome, HDaH, was defined as 180 days minus the days a patient spent in healthcare institutions, including hospitals, skilled nursing facilities, and hospice care. We used generalized linear mixed-effects models with a log (180) offset to estimate the adjusted rate ratios (aRR) and 95% confidence intervals.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The cohort included 122,579 seriously ill older adults,11% (<jats:italic>n<\/jats:italic>\u2009=\u200913,452) of whom had cancer. The median (IQR) HDaH was 115 (26\u2013174) days. Each unit increase in Gagne index score was associated with a 6.0% decrease in the rate of HDaH (aRR: 0.94; 95% CI: 0.94 to 0.94), a pattern observed in both cancer and non-cancer groups. Cancer diagnosis was associated with 7.0% increase in HDaH (aRR: 1.07; 95% CI: 1.07 to 1.07).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>While poor prognosis is associated with fewer healthy days at home, cancer diagnosis is associated with more healthy days at home. Our findings highlight the need for tailored care models to reduce hospitalizations and increase HDaH for patients with serious life-limiting illnesses other than cancer.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12877-025-06160-9","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T08:28:02Z","timestamp":1751531282000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Healthy days at home and prognosis of older adults with cancer and non-cancer serious life-limiting illnesses"],"prefix":"10.1186","volume":"25","author":[{"given":"Oluwaseun J.","family":"Adeyemi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Siman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison M.","family":"Cuthel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith S.","family":"Goldfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corita R.","family":"Grudzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"issue":"6","key":"6160_CR1","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1377\/hlthaff.2011.0922","volume":"31","author":"AK Smith","year":"2012","unstructured":"Smith AK, McCarthy E, Weber E, et al. Half of older Americans seen in emergency department in last month of life; most admitted to hospital, and many die there. Health Aff (Millwood) Jun. 2012;31(6):1277\u201385. https:\/\/doi.org\/10.1377\/hlthaff.2011.0922.","journal-title":"Health Aff (Millwood) Jun"},{"issue":"3","key":"6160_CR2","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.jpainsymman.2010.11.006","volume":"42","author":"KE Steinhauser","year":"2011","unstructured":"Steinhauser KE, Arnold RM, Olsen MK, et al. Comparing three life-limiting diseases: does diagnosis matter or is sick, sick? J Pain Symptom Manage Sep. 2011;42(3):331\u201341. https:\/\/doi.org\/10.1016\/j.jpainsymman.2010.11.006.","journal-title":"J Pain Symptom Manage Sep"},{"key":"6160_CR3","doi-asserted-by":"publisher","unstructured":"Murray SA, Kendall M, Boyd K, Sheikh A. Illness trajectories and palliative care. Bmj. Apr 30. 2005;330(7498):1007-11. https:\/\/doi.org\/10.1136\/bmj.330.7498.1007","DOI":"10.1136\/bmj.330.7498.1007"},{"issue":"4","key":"6160_CR4","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/j.annemergmed.2016.09.018","volume":"69","author":"JM Nagurney","year":"2017","unstructured":"Nagurney JM, Fleischman W, Han L, Leo-Summers L, Allore HG, Gill TM. Emergency department visits without hospitalization are associated with functional decline in older persons. Ann Emerg Med Apr. 2017;69(4):426\u201333. https:\/\/doi.org\/10.1016\/j.annemergmed.2016.09.018.","journal-title":"Ann Emerg Med Apr"},{"issue":"4","key":"6160_CR5","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1016\/j.cger.2023.05.009","volume":"39","author":"CJ Gettel","year":"2023","unstructured":"Gettel CJ, Hastings SN, Biese KJ, Goldberg EM. Emergency Department-to-Community transitions of care: best practices for the older adult population. Clin Geriatr Med Nov. 2023;39(4):659\u201372. https:\/\/doi.org\/10.1016\/j.cger.2023.05.009.","journal-title":"Clin Geriatr Med Nov"},{"key":"6160_CR6","doi-asserted-by":"publisher","unstructured":"Tavares J, Sa-Couto P, Reis JD, Boltz M, Capezuti E. The role of frailty in predicting 3 and 6 months functional decline in hospitalized older adults: findings from a secondary analysis. Int J Environ Res Public Health Jul. 2021;3(13). https:\/\/doi.org\/10.3390\/ijerph18137126.","DOI":"10.3390\/ijerph18137126"},{"issue":"2","key":"6160_CR7","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.annemergmed.2019.01.003","volume":"74","author":"K Ouchi","year":"2019","unstructured":"Ouchi K, George N, Schuur JD, et al. Goals-of-Care conversations for older adults with serious illness in the emergency department: challenges and opportunities. Ann Emerg Med Aug. 2019;74(2):276\u201384. https:\/\/doi.org\/10.1016\/j.annemergmed.2019.01.003.","journal-title":"Ann Emerg Med Aug"},{"issue":"8","key":"6160_CR8","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.1089\/jpm.2019.0467","volume":"23","author":"SE Morris","year":"2020","unstructured":"Morris SE, Nayak MM, Block SD. Insights from bereaved family members about End-of-Life care and bereavement. J Palliat Med Aug. 2020;23(8):1030\u20137. https:\/\/doi.org\/10.1089\/jpm.2019.0467.","journal-title":"J Palliat Med Aug"},{"key":"6160_CR9","doi-asserted-by":"publisher","unstructured":"Motamedi M, Brandenburg C, Bakhit M et al. Concerns and potential improvements in end-of-life care from the perspectives of older patients and informal caregivers: a scoping review. BMC geriatrics. 2021\/12\/20 2021;21(1):729. https:\/\/doi.org\/10.1186\/s12877-021-02680-2","DOI":"10.1186\/s12877-021-02680-2"},{"issue":"3","key":"6160_CR10","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1111\/hex.12860","volume":"22","author":"ET Lewis","year":"2019","unstructured":"Lewis ET, Harrison R, Hanly L, et al. End-of-life priorities of older adults with terminal illness and caregivers: A qualitative consultation. Health Expect Jun. 2019;22(3):405\u201314. https:\/\/doi.org\/10.1111\/hex.12860.","journal-title":"Health Expect Jun"},{"key":"6160_CR11","doi-asserted-by":"publisher","unstructured":"Lam MB, Riley KE, Zheng J, Orav EJ, Jha AK, Burke LG. Healthy days at home: A population-based quality measure for cancer patients at the end of life. Cancer. 2021\/11\/15 2021;127(22):4249\u201357. https:\/\/doi.org\/10.1002\/cncr.33817","DOI":"10.1002\/cncr.33817"},{"issue":"1","key":"6160_CR12","doi-asserted-by":"publisher","first-page":"100378","DOI":"10.1016\/j.hjdsi.2019.100378","volume":"8","author":"LG Burke","year":"2020","unstructured":"Burke LG, Orav EJ, Zheng J, Jha AK. Healthy days at home: A novel population-based outcome measure. Healthcare. 2020;8(1):100378. https:\/\/doi.org\/10.1016\/j.hjdsi.2019.100378. 2020\/03\/01.","journal-title":"Healthcare"},{"issue":"8","key":"6160_CR13","doi-asserted-by":"publisher","first-page":"e2119346","DOI":"10.1001\/jamanetworkopen.2021.19346","volume":"4","author":"C Becker","year":"2021","unstructured":"Becker C, Zumbrunn S, Beck K, et al. Interventions to improve communication at hospital discharge and rates of readmission: A systematic review and Meta-analysis. JAMA Netw Open. 2021;4(8):e2119346\u20132119346. https:\/\/doi.org\/10.1001\/jamanetworkopen.2021.19346.","journal-title":"JAMA Netw Open"},{"key":"6160_CR14","doi-asserted-by":"publisher","first-page":"E74","DOI":"10.5888\/pcd21.240138","volume":"26","author":"DJ Bilicki","year":"2024","unstructured":"Bilicki DJ, Reeves MJ. Outpatient Follow-Up visits to reduce 30-Day All-Cause readmissions for heart failure, COPD, myocardial infarction, and stroke: A systematic review and Meta-Analysis. Preventing Chronic Disease Sep. 2024;26:21:E74. https:\/\/doi.org\/10.5888\/pcd21.240138.","journal-title":"Preventing Chronic Disease Sep"},{"key":"6160_CR15","unstructured":"Hearn K. The Relationship Between Early Discharge Planning and Length of Stay. 2020. MSN Capstone Projects. Paper 66. https:\/\/hdl.handle.net\/10950\/2762."},{"issue":"5","key":"6160_CR16","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.jcjq.2022.01.006","volume":"48","author":"JS House","year":"2022","unstructured":"House JS, Hyde CR, Corwin HL, et al. The impact of palliative medicine consultation on readmission rates and hospital costs in surgical patients requiring prolonged mechanical ventilation. Joint Comm J Qual Patient Saf. 2022;48(5):280\u20136. https:\/\/doi.org\/10.1016\/j.jcjq.2022.01.006.","journal-title":"Joint Comm J Qual Patient Saf"},{"key":"6160_CR17","doi-asserted-by":"publisher","first-page":"k4597","DOI":"10.1136\/bmj.k4597","volume":"364","author":"RD Riley","year":"2019","unstructured":"Riley RD, Moons KGM, Snell KIE, et al. A guide to systematic review and meta-analysis of prognostic factor studies. BMJ. 2019;364:k4597. https:\/\/doi.org\/10.1136\/bmj.k4597.","journal-title":"BMJ"},{"issue":"7","key":"6160_CR18","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1016\/j.jclinepi.2010.10.004","volume":"64","author":"JJ Gagne","year":"2011","unstructured":"Gagne JJ, Glynn RJ, Avorn J, Levin R, Schneeweiss S. A combined comorbidity score predicted mortality in elderly patients better than existing scores. J Clin Epidemiol Jul. 2011;64(7):749\u201359. https:\/\/doi.org\/10.1016\/j.jclinepi.2010.10.004.","journal-title":"J Clin Epidemiol Jul"},{"key":"6160_CR19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2025.01.006","author":"O Adeyemi","year":"2025","unstructured":"Adeyemi O, Hill J, Siman N, Goldfeld KS, Cuthel AM, Grudzen CR. Acute care use and prognosis in older adults presenting to the emergency department. J Pain Symptom Manag. 2025. https:\/\/doi.org\/10.1016\/j.jpainsymman.2025.01.006. \/01\/31\/ 2025;doi:.","journal-title":"J Pain Symptom Manag"},{"key":"6160_CR20","doi-asserted-by":"publisher","unstructured":"Baxter R, Fromme EK, Sandgren A. Patient identification for serious illness conversations: A scoping review. Int J Environ Res Public Health Mar. 2022;31(7). https:\/\/doi.org\/10.3390\/ijerph19074162.","DOI":"10.3390\/ijerph19074162"},{"issue":"12","key":"6160_CR21","doi-asserted-by":"publisher","first-page":"1994","DOI":"10.1001\/jamainternmed.2014.5271","volume":"174","author":"RE Bernacki","year":"2014","unstructured":"Bernacki RE, Block SD. Communication about serious illness care goals: a review and synthesis of best practices. JAMA Intern Med Dec. 2014;174(12):1994\u20132003. https:\/\/doi.org\/10.1001\/jamainternmed.2014.5271.","journal-title":"JAMA Intern Med Dec"},{"key":"6160_CR22","doi-asserted-by":"publisher","unstructured":"Weeks JC, Cook EF, O\u2019Day SJ et al. Relationship between cancer patients\u2019 predictions of prognosis and their treatment preferences. Jama. Jun 3. 1998;279(21):1709-14. https:\/\/doi.org\/10.1001\/jama.279.21.1709","DOI":"10.1001\/jama.279.21.1709"},{"key":"6160_CR23","doi-asserted-by":"publisher","unstructured":"Bernacki RE, Block SD. Serious illness communications checklist. Virtual Mentor. Dec 1. 2013;15(12):1045-9. https:\/\/doi.org\/10.1001\/virtualmentor.2013.15.12.stas1-1312","DOI":"10.1001\/virtualmentor.2013.15.12.stas1-1312"},{"key":"6160_CR24","doi-asserted-by":"publisher","unstructured":"Barker PC, Yamarik RL, Adeyemi O et al. Predictors of Specialty Outpatient Palliative Care Utilization Among Persons With Serious Illness. Journal of Pain and Symptom Management. 2024\/12\/01\/ 2024;68(6):583\u2013593. https:\/\/doi.org\/10.1016\/j.jpainsymman.2024.08.004.","DOI":"10.1016\/j.jpainsymman.2024.08.004"},{"key":"6160_CR25","doi-asserted-by":"publisher","unstructured":"Barnato AE, Cohen ED, Mistovich KA, Chang C-CH. Hospital End-of-Life Treatment Intensity Among Cancer and Non-Cancer Cohorts. Journal of Pain and Symptom Management. 2015\/03\/01\/ 2015;49(3):521\u2013529.e5. https:\/\/doi.org\/10.1016\/j.jpainsymman.2014.06.017.","DOI":"10.1016\/j.jpainsymman.2014.06.017"},{"key":"6160_CR26","doi-asserted-by":"publisher","unstructured":"Bostwick D, Wolf S, Samsa G et al. Comparing the Palliative Care Needs of Those With Cancer to Those With Common Non-Cancer Serious Illness. Journal of Pain and Symptom Management. 2017 \/06\/01\/ 2017;53(6):1079\u20131084.e1. https:\/\/doi.org\/10.1016\/j.jpainsymman.2017.02.014.","DOI":"10.1016\/j.jpainsymman.2017.02.014"},{"issue":"3","key":"6160_CR27","first-page":"144","volume":"3","author":"A Ranganathan","year":"2014","unstructured":"Ranganathan A, Gunnarsson O, Casarett D. Palliative care and advance care planning for patients with advanced malignancies. Annals Palliat Med. 2014;3(3):144\u20139.","journal-title":"Annals Palliat Med"},{"issue":"1","key":"6160_CR28","doi-asserted-by":"publisher","first-page":"11","DOI":"10.2147\/copd.s698","volume":"3","author":"A Spathis","year":"2008","unstructured":"Spathis A, Booth S. End of life care in chronic obstructive pulmonary disease: in search of a good death. Int J Chron Obstruct Pulmon Dis. 2008;3(1):11\u201329. https:\/\/doi.org\/10.2147\/copd.s698.","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"6160_CR29","doi-asserted-by":"publisher","unstructured":"Gebresillassie BM, Attia JR, Mersha AG, Harris ML. Prognostic models and factors identifying end-of-life in non-cancer chronic diseases: a systematic review. BMJ Supportive Palliat Care. 2024;spcare\u20132023. https:\/\/doi.org\/10.1136\/spcare-2023-004656.","DOI":"10.1136\/spcare-2023-004656"},{"key":"6160_CR30","doi-asserted-by":"publisher","unstructured":"Gotanda H, Nuckols TK, Lauzon M, Tsugawa Y. Comparison of advance care planning and End-of-Life care intensity between dementia versus Cancer patients. J Gen Intern Med. Oct 2022;37(13):3251\u20137. https:\/\/doi.org\/10.1007\/s11606-021-07330-2.","DOI":"10.1007\/s11606-021-07330-2"},{"issue":"19","key":"6160_CR31","doi-asserted-by":"publisher","first-page":"3631","DOI":"10.1002\/cncr.33676","volume":"1","author":"SS Nouri","year":"2021","unstructured":"Nouri SS, Barnes DE, Shi Y, et al. The PREPARE for your care program increases advance care planning engagement among diverse older adults with cancer. Cancer Oct. 2021;1(19):3631\u20139. https:\/\/doi.org\/10.1002\/cncr.33676.","journal-title":"Cancer Oct"},{"issue":"9","key":"6160_CR32","doi-asserted-by":"publisher","first-page":"1953","DOI":"10.1093\/annonc\/mdv269","volume":"26","author":"D Hui","year":"2015","unstructured":"Hui D, Bansal S, Strasser F, et al. Indicators of integration of oncology and palliative care programs: an international consensus. Ann Oncol Sep. 2015;26(9):1953\u20139. https:\/\/doi.org\/10.1093\/annonc\/mdv269.","journal-title":"Ann Oncol Sep"},{"key":"6160_CR33","doi-asserted-by":"publisher","unstructured":"Sanders JJ, Temin S, Ghoshal A et al. Palliative Care for Patients With Cancer: ASCO Guideline Update. Journal of Clinical Oncology. 2024\/07\/01 2024;42(19):2336\u20132357. https:\/\/doi.org\/10.1200\/JCO.24.00542","DOI":"10.1200\/JCO.24.00542"},{"issue":"7","key":"6160_CR34","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1001\/jama.2024.23696","volume":"333","author":"CR Grudzen","year":"2025","unstructured":"Grudzen CR, Siman N, Cuthel AM, et al. Palliative care initiated in the emergency department: A cluster randomized clinical trial. JAMA. 2025;333(7):599\u2013608. https:\/\/doi.org\/10.1001\/jama.2024.23696.","journal-title":"JAMA"},{"key":"6160_CR35","doi-asserted-by":"publisher","unstructured":"Chung FR, Turecamo S, Cuthel AM, Grudzen CR. Effectiveness and reach of the primary palliative care for emergency medicine (PRIM-ER) pilot study: a qualitative analysis. J Gen Intern Med. Feb 2021;36(2):296\u2013304. https:\/\/doi.org\/10.1007\/s11606-020-06302-2.","DOI":"10.1007\/s11606-020-06302-2"},{"issue":"7","key":"6160_CR36","doi-asserted-by":"publisher","first-page":"e030099","DOI":"10.1136\/bmjopen-2019-030099","volume":"27","author":"CR Grudzen","year":"2019","unstructured":"Grudzen CR, Brody AA, Chung FR, et al. Primary palliative care for emergency medicine (PRIM-ER): protocol for a pragmatic, Cluster-Randomised, stepped wedge design to test the effectiveness of primary palliative care education, training and technical support for emergency medicine. BMJ Open Jul. 2019;27(7):e030099. https:\/\/doi.org\/10.1136\/bmjopen-2019-030099.","journal-title":"BMJ Open Jul"},{"key":"6160_CR37","doi-asserted-by":"publisher","first-page":"100570","DOI":"10.1016\/j.conctc.2020.100570","volume":"18","author":"J Hill","year":"2020","unstructured":"Hill J, Cuthel AM, Lin P, Grudzen CR. Primary palliative care for emergency medicine (PRIM-ER): applying form and function to a theory-based complex intervention. Contemp Clin Trials Commun Jun. 2020;18:100570. https:\/\/doi.org\/10.1016\/j.conctc.2020.100570.","journal-title":"Contemp Clin Trials Commun Jun"},{"issue":"1","key":"6160_CR38","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s12911-020-1021-7","volume":"28","author":"A Tan","year":"2020","unstructured":"Tan A, Durbin M, Chung FR, et al. Design and implementation of a clinical decision support tool for primary palliative care for emergency medicine (PRIM-ER). BMC Med Inf Decis Mak Jan. 2020;28(1):13. https:\/\/doi.org\/10.1186\/s12911-020-1021-7.","journal-title":"BMC Med Inf Decis Mak Jan"},{"key":"6160_CR39","unstructured":"ClinicalTrials.Gov. Primary Palliative Care for Emergency Medicine (PRIM-ER). U.S. National Library of Medicine. Accessed 12\/3\/2021. https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03424109"},{"key":"6160_CR40","doi-asserted-by":"publisher","unstructured":"Muhandiramge J, Orchard SG, Warner ET, van Londen GJ, Zalcberg JR. Functional decline in the Cancer patient: A review. Cancers (Basel) Mar. 2022;8(6). https:\/\/doi.org\/10.3390\/cancers14061368.","DOI":"10.3390\/cancers14061368"},{"issue":"2","key":"6160_CR41","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1111\/jgs.13948","volume":"64","author":"Z Obermeyer","year":"2016","unstructured":"Obermeyer Z, Clarke AC, Makar M, Schuur JD, Cutler DM. Emergency care use and the medicare hospice benefit for individuals with Cancer with a poor prognosis. J Am Geriatr Soc Feb. 2016;64(2):323\u20139. https:\/\/doi.org\/10.1111\/jgs.13948.","journal-title":"J Am Geriatr Soc Feb"},{"issue":"3","key":"6160_CR42","first-page":"241","volume":"2","author":"K Bahadori","year":"2007","unstructured":"Bahadori K, FitzGerald JM. Risk factors of hospitalization and readmission of patients with COPD exacerbation\u2013systematic review. Int J Chron Obstruct Pulmon Dis. 2007;2(3):241\u201351.","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"3 Suppl","key":"6160_CR43","doi-asserted-by":"publisher","first-page":"es38","DOI":"10.1200\/jop.2012.000564","volume":"8","author":"BA Feinberg","year":"2012","unstructured":"Feinberg BA, Lang J, Grzegorczyk J, et al. Implementation of cancer clinical care pathways: a successful model of collaboration between payers and providers. J Oncol Pract May. 2012;8(3 Suppl):es38\u2013s43. https:\/\/doi.org\/10.1200\/jop.2012.000564.","journal-title":"J Oncol Pract May"},{"key":"6160_CR44","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.2543","author":"AI Khan","year":"2017","unstructured":"Khan AI, Arthurs E, Gradin S, MacKinnon M, Sussman J, Kukreti V. Integrated care planning for Cancer patients: A scoping review. Int J Integr Care. 2017. https:\/\/doi.org\/10.5334\/ijic.2543.","journal-title":"Int J Integr Care"},{"key":"6160_CR45","doi-asserted-by":"publisher","unstructured":"van Hoeve JC, Vernooij RWM, Fiander M, Nieboer P, Siesling S, Rotter T. Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis. Systematic Reviews. 2020\/10\/25 2020;9(1):246. https:\/\/doi.org\/10.1186\/s13643-020-01498-0.","DOI":"10.1186\/s13643-020-01498-0"},{"key":"6160_CR46","doi-asserted-by":"publisher","first-page":"1647","DOI":"10.2147\/copd.S163250","volume":"13","author":"W Bartels","year":"2018","unstructured":"Bartels W, Adamson S, Leung L, Sin DD, van Eeden SF. Emergency department management of acute exacerbations of chronic obstructive pulmonary disease: factors predicting readmission. Int J Chron Obstruct Pulmon Dis. 2018;13:1647\u201354. https:\/\/doi.org\/10.2147\/copd.S163250.","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"6160_CR47","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1186\/s12913-014-0519-z","volume":"14","author":"JN Morris","year":"2014","unstructured":"Morris JN, Howard EP, Steel K, et al. Predicting risk of hospital and emergency department use for home care elderly persons through a secondary analysis of cross-national data. BMC Health Serv Res Nov. 2014;14:14:519. https:\/\/doi.org\/10.1186\/s12913-014-0519-z.","journal-title":"BMC Health Serv Res Nov"},{"issue":"4","key":"6160_CR48","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/j.pcad.2015.09.004","volume":"58","author":"B Ziaeian","year":"2016","unstructured":"Ziaeian B, Fonarow GC. The prevention of hospital readmissions in heart failure. Prog cardiovasc dis. Jan-Feb. 2016;58(4):379\u201385. https:\/\/doi.org\/10.1016\/j.pcad.2015.09.004.","journal-title":"Jan-Feb"},{"issue":"3","key":"6160_CR49","doi-asserted-by":"publisher","first-page":"e210677","DOI":"10.1001\/jamanetworkopen.2021.0677","volume":"4","author":"KL Quinn","year":"2021","unstructured":"Quinn KL, Wegier P, Stukel TA, Huang A, Bell CM, Tanuseputro P. Comparison of palliative care delivery in the last year of life between adults with terminal noncancer illness or Cancer. JAMA Netw Open. 2021;4(3):e210677\u2013210677. https:\/\/doi.org\/10.1001\/jamanetworkopen.2021.0677.","journal-title":"JAMA Netw Open"},{"issue":"7","key":"6160_CR50","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1001\/jama.2024.23696","volume":"18","author":"CR Grudzen","year":"2025","unstructured":"Grudzen CR, Siman N, Cuthel AM, et al. Palliative care initiated in the emergency department: A cluster randomized clinical trial. Jama Feb. 2025;18(7):599\u2013608. https:\/\/doi.org\/10.1001\/jama.2024.23696.","journal-title":"Jama Feb"},{"key":"6160_CR51","doi-asserted-by":"publisher","unstructured":"Chawla N, Yabroff KR, Mariotto A, McNeel TS, Schrag D, Warren JL. Sep. Limited validity of diagnosis codes in Medicare claims for identifying cancer metastases and inferring stage. Ann Epidemiol. 2014;24(9):666\u2009\u2013\u200972, 672.e1-2. https:\/\/doi.org\/10.1016\/j.annepidem.2014.06.099","DOI":"10.1016\/j.annepidem.2014.06.099"},{"key":"6160_CR52","doi-asserted-by":"publisher","first-page":"S14","DOI":"10.1016\/j.jval.2018.04.084","volume":"21","author":"CM Parrinello","year":"2018","unstructured":"Parrinello CM, Seidl-Rathkopf KN, Bennette CS, et al. ICD-Coded information on sites of metastasis in oncology Real-World data is specific but not sensitive. Value Health. 2018;21:S14\u20135. https:\/\/doi.org\/10.1016\/j.jval.2018.04.084.","journal-title":"Value Health"}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-025-06160-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-025-06160-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-025-06160-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T08:28:06Z","timestamp":1751531286000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgeriatr.biomedcentral.com\/articles\/10.1186\/s12877-025-06160-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,3]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6160"],"URL":"https:\/\/doi.org\/10.1186\/s12877-025-06160-9","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,3]]},"assertion":[{"value":"14 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Our study used Centers for Medicare and Medicaid Services\u2019 Claims data of older adults with serious life-limiting illnesses. We obtained waiver of consent to use the data given the study\u2019s geographic breadth and volume of eligible patients. The study was performed according to the guidelines in the Helsinki Declaration. This study was approved by the institutional local ethics committee - the NYU Grossman School of Medicine Institutional Review Board (Study ID i18-00607).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"487"}}