Adjusted Changes in Serious Illness Conversations and End-of-Life Outcomes
deaths, death
Abbreviations: aOR, adjusted odds ratio; ICU, intensive care unit; SIC, serious illness conversation.Adjusted for intervention, clinic group, and wedge, and clustered at the oncologist level.High-risk patients were defined as having a 10% or greater risk of death within 180 days, as identified by a prospectively validated machine learning algorithm.End-of-life inpatient and systemic therapy data available for 1188 patients.Hospice outcomes available for 856 patients who were eligible for health system–affiliated hospice.There were 1417 deaths by the end of follow-up (6.9% of patients), 795 (56.1%) of which were in high-risk patients (mortality rate among high-risk patients, 35.2% [795 of 2261 patients]; rate among non–high-risk patients, 3.4% [622 of 18 245 patients]). Intervention patients were less likely than control patients to receive systemic therapy at the end of life (all decedents: 7.5% [72 of 957 patients] vs 10.4% [24 of 231 patients]; aOR, 0.25 [95% CI, 0.11-0.57]; 