Code Discussion at the Time of Hospital Admission: Too Little, Too Late

Whether hospitalized patients routinely are asked about their care preferences at the time of admission is unclear. In the prospective observational Multicenter Hospitalist Study, researchers enrolled newly admitted patients at six U.S. university-based teaching hospitals in which patients were admitted randomly to hospitalists or nonhospitalists on the general medical services. Children, prison inmates, patients directly admitted to subspecialists or their own primary care physicians, and intensive care unit patients were excluded. From 2002 to 2004, 17,097 inpatients (51% of eligible patients) completed interviews (generally within their first hospital day) and consented to chart review.

Only 1776 patients (10.3%) had documented code discu…