J. Brian Cassel

Cost Savings Associated With US Hospital Palliative Care Consultation Programs

BACKGROUND Hospital palliative care consultation teams have been shown to improve care for adults with serious illness. This study examined the effect of palliative care teams on hospital costs. METHODS We analyzed administrative data from 8 hospitals with established palliative care programs for the years 2002 through 2004. Patients receiving palliative care were matched by propensity score to patients receiving usual care. Generalized linear models were estimated for costs per admission and per hospital day. RESULTS Of the 2966 palliative care patients who were discharged alive, 2630 palliative care patients (89%) were matched to 18,427 usual care patients, and of the 2388 palliative care patients who died, 2278 (95%) were matched to 2124 usual care patients. The palliative care patients who were discharged alive had an adjusted net savings of

Prospective Cohort Study of Hospital Palliative Care Teams for Inpatients With Advanced Cancer: Earlier Consultation Is Associated With Larger Cost-Saving Effect

1696 in direct costs per admission (P = .004) and

Palliative care consultation and hospital length of stay.

279 in direct costs per day (P < .001) including significant reductions in laboratory and intensive care unit costs compared with usual care patients. The palliative care patients who died had an adjusted net savings of

The Business Case for Palliative Care: Translating Research Into Program Development in the U.S.

4908 in direct costs per admission (P = .003) and

Effect of a Home-Based Palliative Care Program on Healthcare Use and Costs.

374 in direct costs per day (P < .001) including significant reductions in pharmacy, laboratory, and intensive care unit costs compared with usual care patients. Two confirmatory analyses were performed. Including mean costs per day before palliative care and before a comparable reference day for usual care patients in the propensity score models resulted in similar results. Estimating costs for palliative care patients assuming that they did not receive palliative care resulted in projected costs that were not significantly different from usual care costs. CONCLUSION Hospital palliative care consultation teams are associated with significant hospital cost savings.

Clinical and financial impact of a palliative care program at a small rural hospital.

PURPOSE Previous studies report that early palliative care is associated with clinical benefits, but there is limited evidence on economic impact. This article addresses the research question: Does timing of palliative care have an impact on its effect on cost? PATIENTS AND METHODS Using a prospective, observational design, clinical and cost data were collected for adult patients with an advanced cancer diagnosis admitted to five US hospitals from 2007 to 2011. The sample for economic evaluation was 969 patients; 256 were seen by a palliative care consultation team, and 713 received usual care only. Subsamples were created according to time to consult after admission. Propensity score weights were calculated, matching the treatment and comparison arms specific to each subsample on observed confounders. Generalized linear models with a γ distribution and a log link were applied to estimate the mean treatment effect on cost within subsamples. RESULTS Earlier consultation is associated with a larger effect on total direct cost. Intervention within 6 days is estimated to reduce costs by -

Cost analysis of a prospective multi-site cohort study of palliative care consultation teams for adults with advanced cancer: Where do cost-savings come from?:

1,312 (95% CI, -

Making the Case for Palliative Care at the System Level: Outcomes Data

2,568 to -

Funding models in palliative care: Lessons from international experience

56; P = .04) compared with no intervention and intervention within 2 days by -

Bringing the economic cost of informal caregiving into focus

2,280 (95% CI, -