Hospital charges for a community inpatient palliative care program.

Area of Science:

• Health Economics
• Palliative Care
• Hospital Administration

Background:

• Defining financial parameters for palliative care (PC) is crucial for sustainable programming.
• The Advanced Illness Assistance (AIA) team at Blount Memorial Hospital (BMH) provides inpatient PC consultations.
• Understanding the financial impact of PC services is essential for healthcare providers.

Purpose of the Study:

• To evaluate the hospital length of stay (LOS) and charges for patients receiving inpatient PC consultations from the AIA team.
• To compare the financial outcomes of AIA patients with a matched reference group of non-AIA patients.
• To estimate potential cost savings associated with PC consultations.

Main Methods:

• Retrospective analysis of 164 inpatient PC consultations by the AIA team at BMH.
• Comparison of AIA patients with a matched reference group from the BMH Atlas database (matched by DRG, ASG, and disposition).
• Evaluation of hospital LOS, total charges, daily charges, and specific charge categories (laboratory, imaging).

Main Results:

• AIA patients had a median LOS of 11 days and mean daily charges of $3,809.
• Patients receiving AIA consultation for nonphysical symptoms had higher mean daily charges.
• AIA patients had significantly lower mean daily charges ($3,117) during follow-up compared to pre-consultation (p=0.04).
• Laboratory and imaging charges decreased significantly during AIA follow-up (p=0.04).
• The reference group had a shorter median LOS (6 days) but significantly higher mean daily charges ($4,105) compared to AIA patients (p=0.006).

Conclusions:

• Inpatient palliative care consultations are associated with reduced hospital charges and length of stay.
• The AIA program demonstrates potential for significant cost savings, estimated at over $1.8 million annually.
• Palliative care services contribute to financial sustainability by optimizing resource utilization.