Abstract
Background: Referrals to palliative care for patients at the end of life in the intensive care unit (ICU) often happen late in the ICU stay, if at all. The integration of a palliative medicine advanced practice nurse (APN) is one potential strategy for proactively identifying patients who could benefit from this service. Objective: To evaluate the association between the integration of palliative medicine APNs into the routine operations of ICUs and hospital costs at 2 different institutions, Montefiore Medical Center (MMC) and Rush University Medical Center. Methods: The association between collaborative palliative care consultation service programs and hospital costs per patient was evaluated for the 2 institutions. Hospital costs were compared for patients with and without a referral to palliative care using Mann-Whitney U tests. Results: Hospital nonroom and board costs at the Weiler campus of MMC were significantly lower for patients with palliative care compared with those who did not receive palliative care (Median = US$6643 vs US$12 399, P <.001). Cost differences for ICU patients with and without palliative care at Rush University Medical Center were not significantly different. Conclusion: Our evaluation suggests that the integration of APNs into a palliative care team for case finding may be a promising strategy, but more work is needed to determine whether reductions in cost are significant.
Original language | English (US) |
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Pages (from-to) | 330-334 |
Number of pages | 5 |
Journal | American Journal of Hospice and Palliative Medicine |
Volume | 34 |
Issue number | 4 |
DOIs | |
State | Published - May 1 2017 |
Externally published | Yes |
Keywords
- advanced practice provider
- economics
- health care costs
- palliative care
- palliative care consultation
- team-based care
ASJC Scopus subject areas
- General Medicine