癌症晚期患者的非计划住院往往是引发治疗目标讨论和入住临终关怀病房的重要事件。晚期入住临终关怀病房，特别是在生命最后阶段入住，与生活质量下降和医疗总费用增加有关。对于固体肿瘤恶性肿瘤患者的住院管理越来越多地由肿瘤学家转移为肿瘤学住院医生负责。然而，关于肿瘤学住院医生对入住临终关怀病房时机的影响，目前知之甚少。比较内科训练的住院医生领导的一个住院肿瘤学服务和肿瘤学家领导的一个服务的出院率和入住临终关怀病房的时间。在Smilow癌症医院，内科训练的住院医师已被整合到两个住院医学肿瘤学服务中的一个中，以便比较新的住院医师领导的服务（简称HS）和传统的肿瘤学家领导的服务（简称TS）。通过电子病历，确认了2021年7月26日至2022年1月31日的出院患者。使用多项式分布的逻辑回归计算团队变量的出院去向的比值比（odds ratio）。使用多元线性回归评估调整后的出院前住院天数。HS有47/400（11.8％）的患者出院入住临终关怀病房，而TS服务有18/313（5.8％）患者出院，因此调整后的比值比为1.94（95％CI为1.07-3.51；p = .03）。调整后的入住临终关怀病房前的平均住院天数为6.83天（95％CI为4.22-11.06)（p = .003）。肿瘤学住院医生改善了住院肿瘤学服务中入住临终关怀病房的利用和入住临终关怀病房转诊的时机。晚期癌症患者往往在临终时被送入医院。这些患者通常预后不良，可能更倾向于关注舒适的临终关怀。在本研究中，肿瘤学住院医生将更高比例的患者接送至住院临终关怀病房，并减少了患者在医院中的停留时间。 © 2023 American Cancer Society.

Unplanned hospitalizations among patients with advanced cancer are often sentinel events prompting goals of care discussions and hospice transitions. Late referrals to hospice, especially those at the end of life, are associated with decreased quality of life and higher total health care costs. Inpatient management of patients with solid tumor malignancies is increasingly shifting from oncologists to oncology hospitalists. However, little is known about the impact of oncology hospitalists on the timing of transition to hospice.To compare hospice discharge rate and time to hospice discharge on an inpatient oncology service led by internal medicine-trained hospitalists and a service led by oncologists.At Smilow Cancer Hospital, internal medicine-trained hospitalists were integrated into one of two inpatient medical oncology services allowing comparison between the new, hospitalist-led service (HS) and the traditional, oncologist-led service (TS). Discharges from July 26, 2021, through January 31, 2022, were identified from the electronic medical record. The odds ratio for discharge disposition by team was calculated by logistic regression using a multinomial distribution. Adjusted length of stay before discharge was assessed using multivariable linear regression.The HS discharged 47/400 (11.8%) patients to inpatient hospice, whereas the TS service discharged 18/313 (5.8%), yielding an adjusted odds ratio of 1.94 (95% CI, 1.07-3.51; p = .03). Adjusted average length of stay before inpatient hospice disposition was 6.83 days (95% CI, 4.22-11.06) for the HS and 16.29 days (95% CI, 7.73-34.29) for the TS (p = .003).Oncology hospitalists improve hospice utilization and time to inpatient hospice referral on an inpatient medical oncology service.Patients with advanced cancer are often admitted to the hospital near the end of life. These patients generally have a poor chance of long-term survival and may prefer comfort-focused care with hospice. In this study, oncology hospitalists discharged a higher proportion of patients to inpatient hospice with less time spent in the hospital before discharge.© 2023 American Cancer Society.