Palliative Care Programs Lead to Cost Savings
Treatment for seriously ill patients cost dramatically less when palliative-care teams in hospitals matched their therapeutic strategies with goals set by patients.
In eight hospitals with such palliative-care programs, adjusted direct costs per admission were $1,696 lower for patients discharged alive compared with others receiving usual care (P=0.004), reported R. Sean Morrison, M.D., of Mount Sinai School of Medicine, and colleagues in the Sept. 8 issue of Archives of Internal Medicine.
The direct-cost savings worked out to an adjusted $174 per day (P<0.001) from a mean of $830 per day under usual care, the researchers said.
Even greater savings were achieved among patients who died — $374 per day in direct costs (P<0.001) and $4,908 per admission (P=0.003). Usual care cost a mean of $1,484 per day for patients who died.
Most physicians know that we spend too much money towards the end of life. Too often we order tests that cannot provide information which will really help the patient. Too often we provide expensive therapies that do not really matter.
Palliative care physicians focus on the patient rather than the diseases – making them fit Osler’s definition of a great physician. We can greatly decrease hospital costs if we expand palliative care programs around this country. Patients and families are usually very grateful when palliative care physicians refocus attention on patient comfort rather than futile attempts to treat terminal disease. Patients and families understand. We need more physicians to understand.
