Palliative care cuts costs as much as 67%

Kaiser Permanente's home-based palliative care program not only increased patient satisfaction but also reduced emergency department visits, inpatient admissions and costs, according to a new report from the Agency for Healthcare Research and Quality (AHRQ) that may reinforce the palliative care push.

The program used a palliative care team focused on pain control and symptom management. Team members included a physician, a nurse with palliative care and pain management experience, a social worker and a chaplain. However, physical therapists, respiratory therapists and home health aides participated when necessary.

The palliative care team also provided ongoing care, support and education to both patients and family members with weekly nurse visits, occasional physician visits, as-needed visits from the social worker and chaplain, and a 24/7 nurse call center, according to the report.

After applying the home-based palliative care model, 93 percent of palliative care patients said they were very satisfied with their care 90 days after enrollment, compared to 81 percent for the usual care group, according to a randomized controlled trial.

Improved satisfaction likely stemmed from more palliative patients dying at home than in the hospital, in accordance with their wishes, the AHRQ report noted.

In addition to boosting patient satisfaction, palliative care programs also improve the bottom line, with palliative care patients costing significantly less than those receiving usual care. For example, average costs for palliative care patients with cancer were 35 percent lower the usual care patients, 67 percent lower for palliative care patients with chronic obstructive pulmonary disease and 52 percent lower for palliative care patients with congestive heart failure.

Given such success, it's not surprising to see palliative care making strides across multiple care settings. For instance, Cleveland Clinic no longer isolates its palliative medicine program to the hospital setting. "In the setting of a complicated illness, people move from hospital to home (and) from home to outpatient clinic and so it's very important to provide continuity of care between those different areas," said program director Declan Walsh, FierceHealthcare reported last week.

For more:
- here's the AHRQ report