Palliative care reduces costs

Hospitals that introduce palliative care for very sick patients have reduced hospital stays and lower costs, according to a study published in JAMA Internal Medicine.

Palliative care is team-based care focused on improving quality of life and reducing suffering for people with serious illness and their families. It can be provided for people of any age and in concert with other treatment modalities.

The study, conducted by the Icahn School of Medicine at Mount Sinai and Trinity College Dublin, pooled data from six prior studies involving over 130,000 adults admitted to hospitals in the United States between 2001 and 2015; of these patients, 3.6% received a palliative care consultation in addition to their other hospital care.

The researchers found that palliative care results in reduced hospital stays and associated cost savings, particularly for patients with the most complex conditions. The study found that:

• hospitals saved on average US $3237 per patient, over the course of a hospital stay, when palliative care was added to their routine care as compared to those who didn’t receive palliative care;
• palliative care was associated with a cost savings — per hospital stay — of US$4251 per patient with cancer and US$2105 for those with non-cancer diagnoses;
• savings were greatest for patients with the highest number of co-existing illnesses.
   

“People with serious and complex medical illness account heavily for healthcare spending, yet often experience poor outcomes,” said the lead study author, Dr Peter May, Research Fellow in Health Economics, Centre for Health Policy and Management, Trinity College Dublin. “The news that palliative care can significantly improve patient experience by reducing unnecessary, unwanted and burdensome procedures, while ensuring that patients are cared for in the setting of their choice, is highly encouraging. It suggests that we can improve outcomes and curb costs even for those with serious illness.”

Palliative care teams provide an extra layer of support to patients, and families of patients, with complex health needs. Palliative care provides expert pain and symptom management guidance in the treatment of serious illness as well as communicating care options before and after discharge. While palliative care has seen a steady rise during the past 30 years, research suggests that acute care hospitals have not leveraged palliative care to its full potential.

The researchers found that the association of palliative care with less intense hospital treatment was most pronounced among those patients with a primary diagnosis of cancer than for those with a noncancer diagnosis, and for individuals with four or more comorbidities compared with those with two or fewer.

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