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Where acute care hospitals can find cost-savings in palliative care

The practice of palliative care is known to make patients more comfortable and now is proven to shorten hospital stays and lower costs.

Jeff Lagasse, Associate Editor

While palliative care has seen a steady rise during the past 30 years, with several advanced centers for the model emerging in the U.S., acute care hospitals have not leveraged palliative care to its full potential.  

Hospital finance and operations executives paying close attention know that nearly every week new ways of reducing expenses emerge. In April, for instance, two unrelated studies found that glucose monitors and adherence to the Food and Drug Administration's sodium targets can bring big opportunities for cost-savings.

[Also: New ways to cut healthcare costs: Sodium targets and glucose monitors]

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Now, add palliative care to that list. The practice is associated with shorter hospital stays and lower costs, and shows its greatest effect among the sickest patients, according to a new study in JAMA Internal Medicine.

Palliative care -- which better aligns medical treatments with patients' goals, aggressively treats symptoms and improves care coordination -- is team-based and focused on improving quality of life, and reducing suffering for people with serious illness. It can be provided for people of any age and in conjunction with other treatments.

The research, conducted at Mount Sinai/Trinity College, pooled data from six prior studies involving more than 130,000 adults admitted to hospitals between 2001 and 2015; of these patients, 3.6 percent received a palliative care consultation in addition to other hospital care.

Hospitals saved, on average, $3,237 per patient over the course of a hospital stay when palliative care was added to their routine regimen, the data showed. Palliative care was associated with a cost savings, per hospital stay, of $4,251 per patient with cancer and $2,105 for those with non-cancer diagnoses. 

Savings were greatest for patients with the highest number of co-existing illnesses. 

Palliative care teams provide an extra layer of support to patients, and families of patients, with complex health needs. It provides expert pain and symptom management guidance in the treatment of serious illness, and communicates care options before and after discharge. 

The researchers also found that the association of palliative care with less intense hospital treatment was most pronounced among those patients with a primary diagnosis of cancer than for those with a non-cancer diagnosis, and for individuals with four or more comorbidities compared with those with two or fewer.

Twitter: @JELagasse
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