Palliative care within 2 days of admission lowered costs by 22% to 33% for patients with cancer and comorbid conditions. In addition, early palliative care reduced direct hospital costs more for patients with a higher number of coexisting conditions. These findings were published in Health Affairs (doi:10.1377/hlthaff.2015.0752).
This is the first study to examine whether the effect of palliative care consultation varies by the number of co-existing chronic conditions. The study was led by researchers at the Icahn School of Medicine at Mount Sinai in New York, New York.
Palliative care incorporates medicine, nursing, social work, and chaplaincy as a team-based specialty. It is focused on improving quality of life for people with serious illnesses by adding a layer of support for patients, their families, and the health care team.
Notably, palliative care is provided in conjunction with all other appropriate medical treatments, including curative and life-prolonging therapies. Programs using palliative care consultation teams have rapidly expanded in recent years. Currently, palliative care teams are available at more than 90% of medium-size to large US hospitals.
In this study, patients with advanced cancer and numerous serious health conditions from 6 hospitals were assigned into 2 groups: the first group received a palliative care team consult in addition to usual care, the second group received only usual care.
Costs were reduced 22% for patients in the palliative care group compared with the group that did not receive a palliative consultation. A cost reduction of up to 32% was seen in the patients with the highest number of comorbidities.
Early palliative consultations with the sickest patients may reduce unwanted aggressive end-of-life care and shorten length of stay in hospital, according to the study’s findings.
“We already know that coordinated, patient-centered palliative care improves care quality, enhances survival, and reduces costs for persons with cancer,” said R. Sean Morrison, MD, director of the National Palliative Care Research Center and professor of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, and lead author of the study.
“Our latest research now shows the strong association between cost and the number of co-occurring conditions. Among patients with advanced cancer and other serious illnesses, aggressive treatments are often inconsistent with patients’ wishes and are associated with worse quality of life compared to other treatments. It is imperative that policymakers act to expand access to palliative care.”
The National Cancer Institute (NCI) and the National Institute of Nursing Research provided support for the study.