Cost and Utilization Outcomes of Patients Receiving Hospital-Based Palliative Care Consultation

Penrod, Joan D.; Deb, Partha; Luhrs, Carol; Dellenbaugh, Cornelia; Zhu, Carolyn W.; Hochman, Tsivia; Maciejewski, Matthew L.; Granieri, Evelyn; Morrison, R. Sean

doi:10.1089/jpm.2006.9.855

Cited by 251 publications

(205 citation statements)

References 37 publications

Supporting

Mentioning

191

Contrasting

Unclassified

Order By: Relevance

“…Observational designs dominate with 9 cohort studies [23][24][25][26][28][29][30][31]33 and 1 randomized controlled trial. 27 Among observational studies there is a wide variation in size with 5 having intervention groups of between 27 and 164 patients, [23][24][25][26]28 and 1 study having 4908 intervention patients. 29 Nine of the studies restrict their perspective to the hospital and do not evaluate patient or caregiver outcomes.…”

Section: Design and Approachmentioning

confidence: 99%

“…29 Nine of the studies restrict their perspective to the hospital and do not evaluate patient or caregiver outcomes. [23][24][25][26][28][29][30][31]33 The remaining article analyzes total health care costs for 6 months postdischarge as well as some patient outcome measures but does not quantify the relationship between the two. 27 While there is variation in terms of hospital type and the label given to multidisciplinary teams, the composition of those teams are broadly consistent.…”

Section: Design and Approachmentioning

confidence: 99%

See 1 more Smart Citation

Economic Impact of Hospital Inpatient Palliative Care Consultation: Review of Current Evidence and Directions for Future Research

May

Normand

Morrison

2014

Journal of Palliative Medicine

Self Cite

141

130

View full text Add to dashboard Cite

Background: Maintaining the recent expansion of palliative care access in the United States is a recognized public health concern. Economic evaluation is essential to validate current provision and assess the case for new programs. Previous economic reviews in palliative care reported on programs across settings and systems; none has examined specifically the hospital consultative model, the dominant model of provision in the United States. Objectives: To review systematically the economic evidence on specialist palliative care consultation teams in the hospital setting, to appraise this evidence critically, and to identify areas for future research in this field. Data Sources: A meta-review (''a review of existing reviews'') was conducted of eight published systematic reviews and one relevant nonsystematic review. To identify articles published outside of the timeframe of these reviews, systematic searches were performed on the PubMed, CINAHL, and EconLit databases. Study Selection: Articles were included if they compared the costs and/or cost effectiveness of a specialist hospital inpatient palliative care consultation for adult patients with those of a comparator. Results: Ten studies were included and these demonstrate a clear pattern of cost-saving impact from inpatient consultation programs. Nevertheless, knowledge gaps still exist regarding the economic effects of these programs. Current evidence has been generated from the hospital perspective; health system costs, patient and caregiver costs, and health outcomes are typically not included. Conclusions: Inpatient palliative care consultation programs have been shown to save hospitals money and to provide improved care to patients with serious illness. With a clear pattern of cost-saving using current methodology, it is timely to begin expanding the scope of economic evaluation in this field. Future research must address the measurement of both costs and outcomes to understand more fully the role that palliative care plays in enhancing value in health care. Relevant domains for such research are identified.

show abstract

Section: Design and Approachmentioning

confidence: 99%

Section: Design and Approachmentioning

confidence: 99%

Economic Impact of Hospital Inpatient Palliative Care Consultation: Review of Current Evidence and Directions for Future Research

May

Normand

Morrison

2014

Journal of Palliative Medicine

Self Cite

141

130

View full text Add to dashboard Cite

show abstract

“…10,[23][24][25][26][27][28][29][30][31] Increased median longevity was observed among patients with small-cell lung cancer in early referral outpatient palliative care settings versus usual care. 32 Patients provided with inpatient palliative care consults were less likely to die in intensive care units and more likely to receive hospice referrals.…”

Section: Palliative Care Interventions Designed To Meet Needs Of Patimentioning

confidence: 99%

Living With Advanced Illness: Longitudinal Study of Patient, Family, and Caregiver Needs

Tallman¹,

Greenwald²,

Reidenouer³

et al. 2012

TPJ

View full text Add to dashboard Cite

“…(20)(21)(22)(23)(24) Additionally, a recent study has also shown that receipt of hospital-based palliative care services is associated with significantly lower likelihood of admission to an ICU and lower inpatient costs. (25) Therefore, available data suggests that high-quality palliative care leads to both improved patient-and family-centered outcomes and decreased costs. It is the intent of this review to highlight the major factors involved in providing palliative and end-of-life care to older patients with lung diseases.…”

Section: Introductionmentioning

confidence: 99%

End-of-Life Considerations in Older Patients Who Have Lung Disease

Stapleton

Curtis

2007

Clinics in Chest Medicine

View full text Add to dashboard Cite

The goal of palliative care is to prevent suffering and manage symptoms, maintain quality of life, and to provide physical, emotional, and spiritual support for patients and their loved ones. Currently, palliative care measures focus largely on patients with cancer and these models have not been effectively applied to patients with chronic lung disease. Patients with lung disease have a reduced quality of life and a burden of symptoms that is at least as great, if not greater than, patients with cancer, and they commonly experience significant pain, dyspnea, and fatigue. In addition, dementia and delirium can often play a significant role in older patients. Research suggests that patients with chronic lung disease receive suboptimal palliative care due in large part to inadequate communication with their physicians. When patients have made decisions about life-sustaining therapies, physicians often either don't know the patients' wishes or misunderstand them. Additionally, depression, which is common in older patients with chronic illness, may influence patients' decisions about end-of-life care. Clinicians should realize that the vast majority of patients want more information about endof-life care and that efforts to initiate and improve communication with their patients are important. This article reviews the potential for enhanced palliative care for older patients with chronic lung disease.

show abstract

Cost and Utilization Outcomes of Patients Receiving Hospital-Based Palliative Care Consultation

Abstract: PC was associated with significantly lower likelihood of ICU use and lower inpatient costs compared to UC. Our findings coupled with those indicating better patient and family outcomes with PC suggest both a cost and quality incentive for hospitals to develop PC programs.

Cited by 251 publications

References 37 publications

Economic Impact of Hospital Inpatient Palliative Care Consultation: Review of Current Evidence and Directions for Future Research

Economic Impact of Hospital Inpatient Palliative Care Consultation: Review of Current Evidence and Directions for Future Research

Living With Advanced Illness: Longitudinal Study of Patient, Family, and Caregiver Needs

End-of-Life Considerations in Older Patients Who Have Lung Disease

Contact Info

Product

Resources

About