Early Palliative Care Consults Reduce Patients’ Length of Stay and Overall Hospital Costs

Abstract

Background: Palliative care improves health outcomes and satisfaction and supports decision-making for patients and families during challenging times in their lives. Earlier referral for consults has demonstrated increased costs savings. Hypothesis: Education proposing physicians order a palliative care consult within 3 days of patient hospital admission will decrease patient length of stay (LOS) and overall costs as well as expedite the transition to next level of care. Design/Method: A descriptive retrospective cohort study was completed using de-identified data originally captured for a system-wide initiative at a large acute care hospital in Illinois. Hospitalists were selected as the pilot group and received education encouraging physicians to order palliative care consults within 3 days of patient admission. Non-hospitalists (control group) did not receive the education. All results were compared to a 3-month baseline period. Results: A total of 711 patients were included in this study (367 baseline, 138 pilot, 206 controls). The baseline pre-consult LOS of 4.8 days was reduced to 3.7 days in the pilot group, representing a > 1 day decrease in the timing of palliative consult. The pilot demonstrated a direct cost savings of 26% over the 3-months pilot period. Additionally, a 2-day reduction in overall LOS was demonstrated in the pilot group compared to both the baseline and control groups. Conclusions: This pilot demonstrated an ability to change the timing of new palliative care consults, resulting in direct cost savings and LOS reduction. These results demonstrated the need for a larger study to confirm these findings.

Effects of the Time of Hospice and Palliative Care Enrollment before Death on Morphine, Length of Stay, and Healthcare Expense in Patients with Cancer in Taiwan

“…At different timepoints before death in the same year, the total length of hospital stay increased as the time of death approached in both enrolled and non-enrolled patients, but the difference between the two groups was not significant, which is inconsistent with the findings of previous studies. For example, studies from the US noted that patients who received hospice and palliative care consultations had shorter hospital stays within 3 months before death than patients who did not [34,35]. Moreover, other studies from the US showed that the longer the length of hospice and palliative care, the greater the reduction in the length of hospital stay [36].…”

Managing the end of life in COVID patients. The role of palliative care in emergency departments during the pandemic

“…In conclusion, this brief analysis suggests the need to deepen and, probably, redefine the professional, ethical and clinical role of palliative care teams, not only in the management of COVID patients, but also in the healthcare system as a whole. This also requires a reflection on current clinical-care practices and on how to include an early integration of palliative care team knowledge and expertise at the service of collective and individual health (Zaborowski et al, 2022 ).…”