Development of hospice care at Methodist Hospital

Patients who are terminally ill in hospital are one type of the patient population affected by health-care reform. A hospital-hospice programme may be an appropriate alternative for their care. This article describes the process of creating a hospital-hospice programme. In order to identify the potential patient population, a review of the charts of all patients who died at Methodist Hospital over a 3-month period was carried out by the hospice medical director. The purpose of this review was to identify 'hospice-appropriate' patients and to determine the number of days of the patients' hospital stay that were appropriate for hospice care. The costs of the 'appropriate' hospice patients were reviewed to evaluate whether a reduction in charges would be accomplished by the implementation of this programme. The reduction in charges included treatment and tests that would not have been undertaken had the 'hospice-appropriate' patient been admitted to the hospital-hospice programme. A reduction in charges totalling several hundred thousand dollars occurred during the first year of the hospital-hospice programme's existence.