Patterns of Cost for Patients Dying in the Intensive Care Unit and Implications for Cost Savings of Palliative Care Interventions

Although the clinical benefits associated with hospital-based palliative care (PC) consultation teams are well established, few studies address the potential economic impact of these services. This study aimed to examine the effect of hospital-based PC teams on hospital costs for patients who died in the hospital, as well as for those discharged alive. Eight diverse hospital settings with established PC teams were chosen, and administrative data relating to direct costs (including laboratory, diagnostic imaging, pharmacy, and intensive care unit [ICU] costs) were analyzed. Propensity scoring was used to match PC patients with usual care (UC) patients. Of 2,630 PC patients who were discharged alive, net savings of $2,642 per admission were calculated, compared with 18,427 UC patients. For the 2,278 PC patients who died in the hospital, savings of $4,908 per admission were seen, when compared with 2,124 UC patients, confirming the additional economic benefits associated with hospital-based PC teams.

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Faculty Opinions recommendation of Palliative Care for Patients Dying in the Intensive Care Unit with Chronic Lung Disease Compared with Metastatic Cancer.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726099448.793539213 ◽

2017 ◽

Author(s):

Sergio Harari ◽

Antonella Caminati

Keyword(s):

Intensive Care Unit ◽

Palliative Care ◽

Intensive Care ◽

Lung Disease ◽

Chronic Lung Disease ◽

Metastatic Cancer

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Assessment of Palliative Care Needs in a Kenyan Intensive Care Unit Using a Trigger-Based Model.

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2020.12.016 ◽

2021 ◽

Author(s):

Linda Barasa ◽

Jasmit Shah ◽

John Weru ◽

Sayed Ali Karar

Keyword(s):

Intensive Care Unit ◽

Palliative Care ◽

Intensive Care ◽

Care Needs ◽

Palliative Care Needs

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What do I do? Developing a taxonomy of chaplaincy activities and interventions for spiritual care in intensive care unit palliative care

BMC Palliative Care ◽

10.1186/s12904-015-0008-0 ◽

2015 ◽

Vol 14 (1) ◽

Cited By ~ 48

Author(s):

Kevin Massey ◽

Marilyn JD Barnes ◽

Dana Villines ◽

Julie D Goldstein ◽

Anna Lee Hisey Pierson ◽

...

Keyword(s):

Intensive Care Unit ◽

Palliative Care ◽

Intensive Care ◽

Spiritual Care

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Quality of palliative care in intensive care unit “X” Hospital Indonesia

Enfermería Clínica ◽

10.1016/j.enfcli.2020.07.003 ◽

2020 ◽

Vol 30 ◽

pp. 16-19

Author(s):

Ifa Hafifah ◽

Syamsul Arifin ◽

Dhemes Alin ◽

Isnawati

Keyword(s):

Intensive Care Unit ◽

Palliative Care ◽

Intensive Care

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Palliative care practice in the intensive care unit: Perceptions of registered nurses

Australian Critical Care ◽

10.1016/j.aucc.2009.12.022 ◽

2010 ◽

Vol 23 (1) ◽

pp. 39

Author(s):

A. Bone ◽

T. Elderkin

Keyword(s):

Intensive Care Unit ◽

Palliative Care ◽

Intensive Care ◽

Registered Nurses ◽

Care Practice

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Integrating Palliative Care Into a Neurosurgical Intensive Care Unit (NS-ICU): A Quality Improvement (QI) Project

American Journal of Hospice and Palliative Medicine® ◽

10.1177/10499091211045616 ◽

2021 ◽

pp. 104990912110456

Author(s):

Choo Hwee Poi ◽

Mervyn Yong Hwang Koh ◽

Tessa Li-Yen Koh ◽

Yu-Lin Wong ◽

Wendy Yu Mei Ong ◽

...

Keyword(s):

Intensive Care Unit ◽

Palliative Care ◽

Intensive Care ◽

Quality Improvement ◽

Care Team ◽

Referral Rates ◽

Care Plans ◽

Neurosurgical Patients ◽

Neurosurgical Intensive Care ◽

Neurosurgical Intensive Care Unit

Objectives: We conducted a pilot quality improvement (QI) project with the aim of improving accessibility of palliative care to critically ill neurosurgical patients. Methods: The QI project was conducted in the neurosurgical intensive care unit (NS-ICU). Prior to the QI project, referral rates to palliative care were low. The ICU-Palliative Care collaborative comprising of the palliative and intensive care team led the QI project from 2013 to 2015. The interventions included engaging key stake-holders, establishing formal screening and referral criteria, standardizing workflows and having combined meetings with interdisciplinary teams in ICU to discuss patients’ care plans. The Palliative care team would review patients for symptom optimization, attend joint family conferences with the ICU team and support patients and families post-ICU care. We also collected data in the post-QI period from 2016 to 2018 to review the sustainability of the interventions. Results: Interventions from our QI project and the ICU-Palliative Care collaborative resulted in a significant increase in the number of referrals from 9 in 2012 to 44 in 2014 and 47 the year later. The collaboration was beneficial in facilitating transfers out of ICU with more deaths outside ICU on comfort-directed care (96%) than patients not referred (75.7%, p < 0.05). Significantly more patients had a Do-Not-Resuscitation (DNR) order upon transfer out of ICU (89.7%) compared to patients not referred (74.2.%, p < 0.001), and had fewer investigations in the last 48 hours of life (p < 0.001). Per-day ICU cost was decreased for referred patients (p < 0.05). Conclusions: Multi-faceted QI interventions increased referral rates to palliative care. Referred patients had fewer investigations at the end-of-life and per-day ICU costs.

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