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Research
Open Access

Association between Goals of Care Designation orders and health care resource use among seriously ill older adults in acute care: a multicentre prospective cohort study

Madalene A. Earp, Konrad Fassbender, Seema King, Maureen Douglas, Patricia Biondo, Amanda Brisebois, Sara N. Davison, Winnie Sia, Eric Wasylenko, LeAnn Esau and Jessica Simon
November 01, 2022 10 (4) E945-E955; DOI: https://doi.org/10.9778/cmajo.20210155
Madalene A. Earp
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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Konrad Fassbender
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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Seema King
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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Maureen Douglas
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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Patricia Biondo
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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Amanda Brisebois
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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Sara N. Davison
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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Winnie Sia
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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Eric Wasylenko
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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LeAnn Esau
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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Jessica Simon
Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
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Article Information

vol. 10 no. 4 E945-E955
DOI 
https://doi.org/10.9778/cmajo.20210155
PubMed 
36319025
History 
  • Published online November 1, 2022.
Copyright & Usage 
© 2022 CMA Impact Inc. or its licensors This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/

Author Information

  1. Madalene A. Earp, PhD,
  2. Konrad Fassbender, PhD,
  3. Seema King, MSc MSW,
  4. Maureen Douglas, JD,
  5. Patricia Biondo, PhD,
  6. Amanda Brisebois, MD MSc,
  7. Sara N. Davison, MD MSc,
  8. Winnie Sia, MD,
  9. Eric Wasylenko, MD MHSc,
  10. LeAnn Esau, RN,
  11. Jessica Simon, MB ChB
  1. Division of Palliative Medicine, Department of Oncology (Earp), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Fassbender), Grey Nuns Community Hospital, St. Marguerite Health Services Centre; Division of Palliative Care Medicine, Department of Oncology (Fassbender), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (King), Cumming School of Medicine, University of Calgary; Division of Palliative Medicine, Department of Oncology (Douglas), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Covenant Health Palliative Institute (Douglas), Grey Nuns Community Hospital, St. Marguerite Health Services Centre, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Biondo), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Medicine and Oncology (Palliative Care) (Brisebois) and Department of Medicine (Davison, Sia), University of Alberta, Edmonton, Alta.; Division of Palliative Medicine, Department of Oncology (Wasylenko), Cumming School of Medicine, University of Calgary, Calgary, Alta.; John Dossetor Health Ethics Centre, Faculty of Medicine and Dentistry (Wasylenko), University of Alberta, Edmonton, Alta.; Alberta Health Services, South Zone Seniors Health Integrated Home Care/Palliative Care (Esau), Edmonton, Alta.; Departments of Oncology, Medicine and Community Health Sciences (Simon), University of Calgary, Calgary, Alta.
  1. Correspondence to: Jessica Simon, Jessica.simon{at}albertahealthservices.ca
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Association between Goals of Care Designation orders and health care resource use among seriously ill older adults in acute care: a multicentre prospective cohort study
Madalene A. Earp, Konrad Fassbender, Seema King, Maureen Douglas, Patricia Biondo, Amanda Brisebois, Sara N. Davison, Winnie Sia, Eric Wasylenko, LeAnn Esau, Jessica Simon
Oct 2022, 10 (4) E945-E955; DOI: 10.9778/cmajo.20210155

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Association between Goals of Care Designation orders and health care resource use among seriously ill older adults in acute care: a multicentre prospective cohort study
Madalene A. Earp, Konrad Fassbender, Seema King, Maureen Douglas, Patricia Biondo, Amanda Brisebois, Sara N. Davison, Winnie Sia, Eric Wasylenko, LeAnn Esau, Jessica Simon
Oct 2022, 10 (4) E945-E955; DOI: 10.9778/cmajo.20210155
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