Cost Savings Associated with US Hospital Palliative Care Consultation Programs
By instituting palliative care consultation programs, hospitals can save thousands of dollars per admission of adults with serious illness, according to what claims to be the first empirical study of sufficient size and diversity to produce generalizable findings.
Palliative care focuses on improving the quality of life for acutely ill patients and their families but, unlike hospice care, is provided simultaneously with all other disease-directed treatments. This study examined data from eight geographically and structurally diverse hospitals serving low, medium and high-cost markets, including 49,973 patients discharged alive and 4,726 patients who died in the hospital.
- Palliative care consultation seems to “fundamentally shift” the course of care off the usual hospital pathway and, in doing so, significantly reduces costs.
- Direct hospital costs could be reduced by almost $1,700 per admission ($174 per day) for live discharges and by almost $5,000 per admission ($374 per day) for patients who died.
- The average 400-bed hospital providing palliative care consultation to 500 patients during the year could see an annual net savings of $1.3 million.
- Decreases in costs consistently occurred 48 hours after consultation began.
The authors believe this study provides evidence of an additional value of palliative consultation teams, namely, that in addition to improving the quality of care, such consultation is more cost effective. The impact of such programs could be increasingly significant in coming years as the proportion of older, complex and chronically ill patients increases.