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The triad that matters: palliative medicine, code status, and health care costs
Brian G Celso1, Senthil Meenrajan
1Department of Psychiatry, University of Florida College of Medicine, Jacksonville, FL 32209, USA. Brian.Celso@jax.ufl.edu
Introduction:
Delayed discussion of a patient's code status can lead to shortsighted care plans that increase hospital length of stay (LOS) and costs.
Methods:
Retrospective study compared intensive care unit (ICU) patients who accepted verses rejected palliation and examined the relationships between 5 predictor variables with the outcome variables ICU LOS and total hospital LOS, and total direct and variable hospital cost.
Results:
A significant number of patients who accepted palliative care agreed to a hospice referral or expired in the hospital. The relationships between days until a family conference, do-not-resuscitate (DNR) order, and the number of invasive procedures were significant.
Conclusions:
The amount of time that expires until the issue of code status was settled to clearly related to utilization of hospital resources.
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