A High-Volume Specialist Palliative Care Unit and Team May Reduce In-Hospital End-of-Life Care Costs
Journal of Palliative MedicinePublished 1 October 2003
Thomas J. Smith, Patrick J. Coyne, Brian Cassel, Lynne Penberthy, Alison Hopson, Mary Ann Hager
Citations256
SJR quartileQ1
SJR score0.83
SNIP0.96
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Appropriate standardized care of medically complex terminally ill patients in a high-volume, specialized unit may significantly lower cost.
Abstract
Appropriate standardized care of medically complex terminally ill patients in a high-volume, specialized unit may significantly lower cost. These results should be confirmed in a randomized study but such studies are difficult to perform.
Keywords
Medicine
JAMAA controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). The SUPPORT Principal Investigators
2,779 Citations1995Alfred F. Connors, Neal V. Dawson +198 more
The phase I observation of SUPPORT confirmed substantial shortcomings in care for seriously ill hospitalized adults and the phase II intervention failed to improve care or patient outcomes.
New England Journal of MedicineTrends in Medicare Payments in the Last Year of Life
717 Citations1993James Lubitz, Gerald F. Riley
There is no evidence that persons in the last year of life account for a larger share of Medicare expenditures than in earlier years, and the same forces that have acted to increase overall Medicare expenditures have affected care for both decedents and survivors.
National Academies Press eBooksEnsuring Quality Cancer Care
527 Citations1999Maria Hewitt
The Cancer Care 'System' and Health Services Research in Cancer Care: defining and Assessing Quality Cancer Care and findingings and Recommendations.
New England Journal of MedicineThe Economics of Dying -- The Illusion of Cost Savings at the End of Life
344 Citations1994Ezekiel Emanuel, Linda L. Emanuel
A proposal would require persons enrolling in a health care plan to complete an advance directive and hospitals to establish guidelines to identify and reduce futile care at the end of life.
Medical CareMedicare Payments from Diagnosis to Death for Elderly Cancer Patients by Stage at Diagnosis
336 Citations1995Gerald F. Riley, Arnold L. Potosky +2 more
Journal of Clinical OncologyEnsuring Quality Cancer Care by the Use of Clinical Practice Guidelines and Critical Pathways
241 Citations2001Thomas J. Smith, Bruce E. Hillner
Improvements have been demonstrated in compliance with evidence-based guidelines or evidence- based medicine, and in short-term length of stay, complication rates, and financial outcomes.
BMJRandomised controlled trial comparing hospital at home care with inpatient hospital care. I: three month follow up of health outcomes
227 Citations1998Sasha Shepperd, Diana Harwood +4 more
BMJRandomised controlled trial of effects of coordinating care for terminally ill cancer patients.
213 Citations1992J Addington-Hall, L Macdonald +5 more
This coordinating service made little difference to patient or family outcomes, perhaps because the service did not have a budget with which it could obtain services or because the professional skills of the nurse-coordinators may have conflicted with the requirements of the coordinating role.
BMJRandomised controlled trial comparing hospital at home care with inpatient hospital care. II: cost minimisation analysis
179 Citations1998Sasha Shepperd, Diana Harwood +3 more
BMJRandomised controlled trial comparing effectiveness and acceptability of an early discharge, hospital at home scheme with acute hospital care
167 Citations1998Suzanne H Richards, Joanna Coast +4 more
Palliative MedicineA randomized controlled trial of the cost-effectiveness of a district co-ordinating service for terminally ill cancer patients
116 Citations1996J. Raftery, JM Addington-Hall +5 more
The co-ordination service for cancer patients who were terminally ill with a prognosis of less than one year was more cost effective than standard services, due to achieving the same outcomes at lower service use, particularly inpatient days in acute hospital.
New England Journal of MedicineControlling Health Care Expenditures
83 Citations2001Daniel M. Blumenthal
After a few years of success in controlling the costs of health care, the United States once again faces the challenge of what, if anything, to do about skyrocketing health care expenditures.
Archives of Internal MedicineIs Economic Hardship on the Families of the Seriously Ill Associated With Patient and Surrogate Care Preferences?
79 Citations1996Kenneth E. Covinsky
PubMedUnscheduled readmissions for uncontrolled symptoms. A health care challenge for nurses.
70 Citations1995Marcia Grant, B. R. Ferrell +2 more
Findings indicate that strategies were effective in reducing the number of readmissions for uncontrolled pain.
Journal of Hospital MedicinePalliative care in hospitals
58 Citations2006Diane E. Meier
Why hospital-based palliative care programs have proliferated, how they typically function, and what data exist as to their effectiveness are examined.
Journal of Palliative MedicineThe Impact of a Regional Palliative Care Program on the Cost of Palliative Care Delivery
52 Citations2000Éduardo Bruera, Catherine M. Neumann +4 more
The results suggest that the establishment of an integrated palliative care program reduced the cost of care and savings in acute-care facility costs after its implementation.
The Journal of Rural HealthA Rural Cancer Outreach Program Lowers Patient Care Costs and Benefits Both the Rural Hospitals and Sponsoring Academic Medical Center
33 Citations1999Christopher E. Desch, Michael Grasso +6 more
The Rural Cancer Outreach Program between two rural hospitals and the Medical College of Virginia's Massey Cancer Center was developed to bring state-of-the-art cancer care to medically underserved rural patients and was associated with lower overall cancer treatment costs.
PubMedCancer treatment in rural areas.
21 Citations1992C E Desch, Thomas J. Smith +3 more
The needs and barriers to access in rural Virginia, the structural elements of the Rural Cancer Outreach Program, and the health policy issues that result when subspecialty care is exported to disadvantaged areas are described.
Palliative & Supportive CareCommentary: Is there a model for demonstrating a beneficial financial impact of initiating a palliative care program by an existing hospice program?
11 Citations2004Steven D. Passik, C. O. Ruggles +5 more
It is suggested that an avenue for future exploration is whether partnering between hospitals and hospice programs can defray some of the costs incurred by the palliative care program (that might otherwise be passed on to hospice) in anticipation of cost savings.
