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Palliative care programs have been shown to reduce the overall cost of care, particularly if a palliative care consult is conducted early in a hospital admission. A previous analysis of data from palliative care patients at Advocate Aurora Health, a not-for-profit, integrated health systems in the United States, demonstrated that patients who had a referral to palliative care by day 3 of admission to hospital had a lower overall cost of care. While it is well accepted that referral to palliative care early in a hospital stay has many benefits, there are few examples in the literature of how this may be operationalized.
Zaborowski and colleagues (1) conducted a pilot study to examine the impact of education encouraging hospitalists to order palliative care consults within 3 days of patient admission to hospital. The goal was to optimize the benefits of palliative care by conducting a palliative consult sooner in the patient’s hospital stay.
All hospitalists employed by one site of Advocate Aurora Health received a 30-minute education session on the benefits of early referral to palliative care and were encouraged to refer patients by day 3 of admission throughout the 3-month pilot. Data from patients referred by a hospitalist (“pilot”) was then compared to data for patients referred by any other physician to palliative care (“control”) and to a baseline of all patients referred to palliative care during the 3-months prior to the pilot.
Total length of stay (LOS), pre-consult LOS and average direct costs decreased in the pilot group compared to the control and baseline groups. Post-consult LOS did not differ in the 3 groups. There was no significant difference in diagnoses in the pilot versus the control groups.
The authors concluded that education of benefits of an earlier palliative care consult and reinforcement of these benefits was effective in reducing the time between admission to hospital and palliative care consult.
- Zaborowski, N., Scheu, A., Glowacki, N., Lindell, M., & Battle-Miller, K. (2022). Early Palliative Care Consults Reduce Patients’ Length of Stay and Overall Hospital Costs. American Journal of Hospice and Palliative Medicine®, 10499091211067811. Available from: https://journals.sagepub.com/doi/full/10.1177/10499091211067811
