Early palliative care can save money, reduce patient stay in hospital

While the clinical benefits of early palliative care are well known, new research in the Journal of Clinical Oncology also indicates the programs can reduce both hospital costs and lengths of stay.

Researchers evaluated data from 969 patients with advanced cancer who were admitted to five separate U.S. hospitals with well-established palliative programs between 2007 and 2011. Of those patients, a palliative care consultation team saw 256, while the other 713 received usual care. Researchers also looked at how soon after admission patients received that consultation.

In terms of cost, the research team estimated that palliative intervention within six days of hospital admission reduced costs by 14 percent--or an estimated $1,312--when compared with no intervention. When the intervention took place even earlier, within two days of admission, costs were reduced by an estimated $2,280 or a 24 percent reduction. The cost savings resulted from a reduced length of stay in the hospital and a reduced intensity of that stay. A care consult within two days of admission resulted in a 13 percent reduction in length of stay. 

Palliative care also reduced laboratory, intensive care unit, and pharmacy costs, the researchers found. 

"For studies from the hospital perspective, the obvious question is: how else does treatment effect vary," Peter May, of the Center for Health Policy and Management at Trinity College in Dublin, Ireland and the Ichan School of Medicine at Mount Sinai, New York, told HemOnc Today. "What are the circumstances--when, how, where, for whom--that palliative care interventions are most appropriate, most cost-effective and most useful? It is also important to start looking beyond the hospital perspective."

Palliative care can continue to benefit patients once they are released from the hospital. A pilot program, described in Oncology Nurse Advisor, used nurse coordinators who made home visits twice a week to provide care and support for patients in rural communities. The nurse coordinators helped manage the patient's symptoms, answer questions, and teach the patient and family members proper care. By meeting quality measures, palliative care providers can significantly reduce patients' risk of unnecessary physical and emotional discomfort.

In order to improve end-of-life care for patients, one physician said its time providers are reimbursed for the time they spend discussing treatment options and care preferences with patients and their families. In an opinion piece in Forbes, Bill Frist, M.D., said he is encouraged to see more government initiatives to improve end-of-life care.

To learn more:
- here's the article
- find the study
- check out the report on home visits
- read the opinion piece

 

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