Making the Case for Palliative Care at the System Level: Outcomes Data

Area of Science:

• Healthcare Management
• Palliative Care
• Health Economics

Background:

• Healthcare systems are increasingly integrating palliative care (PC) programs across multiple hospitals.
• This integration aims to standardize care, improve quality, and reduce overall healthcare expenditures.
• Palliative care development varied across seven federated hospitals prior to system integration.

Purpose of the Study:

• To demonstrate the systemwide benefits of integrated palliative care programs.
• To evaluate the impact of early palliative care consultation on key healthcare metrics.

Main Methods:

• Descriptive study utilizing retrospective medical records from seven hospitals.
• Analysis of length of stay (LOS), mortality rates, readmission rates, intensive care unit (ICU) days saved, cost avoidance, and hospice referrals.
• Modified matched-pair analysis to compare PC patients with non-PC patients.

Main Results:

• Early PC consultation (within 48 hours) correlated with shorter LOS, reduced costs, and decreased mortality.
• Significant reductions in 30, 60, and 90-day readmissions were observed post-PC consult.
• Systemwide, PC services facilitated a substantial increase in hospice referrals and demonstrated significant cost avoidance.
• A pilot project in the ICU showed over $600,000 in cost reduction and 315 saved ICU days.

Conclusions:

• Early integration of palliative care services yields significant net benefits for healthcare systems.
• Systemwide palliative care is crucial for improving quality and reducing costs, aligning with trends like bundled payments and risk-holding strategies.
• Palliative care plays a vital role in the future of healthcare system management and cost-effectiveness.