Inpatient palliative care saves money, but many programs fall short

Done properly and comprehensively, inpatient palliative care saves hospitals money, but far too few have a program in place.

Researchers from Johns Hopkins Health System conducted an analysis that found an inpatient palliative care program could save hospitals nearly $4 million annually, according to Medscape. After five years, such a program could save hospitals more than $19 million, according to research presented at the Palliative Care in Oncology Symposium. As a result of the findings, Johns Hopkins will expand its palliative care unit from six beds to 11, according to the article.

"We never set out to save money, but we thought if we discern people's wishes as to what they want and then put in place a team to manage those wishes, you might break even," Thomas J. Smith, M.D., the study's senior author, told Medscape. "That was our initial hypothesis. But it turns out that we did more than break even."

Moreover, another study presented at the same event found inpatient palliative care improves quality of life for patients hospitalized for hematopoietic stem cell transplantation (HCT), according to Oncology Nurse Advisor. Researchers enrolled 160 patients admitted for HTC in such a program and found significant improvements in quality of life, anxiety, symptom burden and depression by the second week.

Despite this, research published in Health Affairs found only 1 in 4 hospitals had palliative care teams with the capabilities recommended by the Joint Commission. Of 410 programs analyzed, about a third had no paid medical doctor or osteopath, while nearly 2 of 3 had no funded chaplain. The research covered results through 2013, and it’s likely some hospitals have improved in the meantime, palliative care physician Robert Arnold, M.D., told Reuters. “My guess is that it’s better now, and even if it’s better, it’s still inadequate to do the kind of culture change that seriously ill patients need,” he said.