The Association of Standardized Documentation of Serious Illness Conversations With Healthcare Utilization in Hospitalized Patients: A Propensity Score Matched Cohort Analysis.

Only 59 encounters had a documented serious illness conversation, and 58 were included in the matched analysis, so the number with documentation was small. The study was retrospective, and clinicians may have documented a serious illness conversation because they already planned palliative care, code status change, or hospice referral. Serious illness conversations documented outside the structured electronic health record module were not studied, and controls may have had such conversations in other notes. Frailty and failure to thrive were not included in the matching, so unmeasured differences between groups may remain. The study did not assess quality of care or health status outcomes, and it was done at one hospital.

No potential conflicts of interest were declared. The work was supported by a grant from the Controlled Risk Insurance Company, and the funder had no role in design, conduct, data collection, analysis, interpretation, or manuscript preparation.

Do not conclude that documenting a serious illness conversation causes more palliative care consults, code status changes, or hospice referrals. This was a retrospective matched cohort, and clinicians may have started or documented conversations because they already planned those outcomes.