Evaluating the Economic Impact of Palliative and End-of-Life Care Interventions on Intensive Care Unit Utilization and Costs from the Hospital and Healthcare System Perspective.

Abstract:

:Purpose of report: Understanding the impact of palliative care interventions on intensive care unit (ICU) costs and utilization is critical for demonstrating the value of palliative care. Performing these economic assessments, however, can be challenging. The purpose of this special report is to highlight and discuss important considerations when assessing ICU utilization and costs from the hospital perspective, with the goal of providing recommendations on methods to consider for future analyses. FINDINGS:ICU length of stay (LOS) and associated costs of care are common and important outcome measures, but must be analyzed properly to yield valid conclusions. There is significant variation in costs by day of stay in the ICU with only modest differences between an ICU day at the end of a stay and the first day on the acute care floor; this variation must be appropriately accounted for analytically. Furthermore, reporting direct variable costs, in addition to total ICU costs, is needed to understand short-term and long-term impact of a reduction in LOS. Importantly, incentives for the hospital to realize savings vary depending on reimbursement policies. SUMMARY:ICU utilization and costs are common outcomes in studies evaluating palliative care interventions. Accurate estimation and interpretation are key to understanding the economic implications of palliative care interventions.

journal_name

J Palliat Med

authors

Khandelwal N,Brumback LC,Halpern SD,Coe NB,Brumback B,Curtis JR

doi

10.1089/jpm.2016.0548

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

1314-1320

issue

12

eissn

1096-6218

issn

1557-7740

journal_volume

20

pub_type

杂志文章
  • The Impact of Urban Zen Integrative Therapy on Symptoms and Health-Related Quality of Life for Patients with Pulmonary Hypertension.

    abstract:: Background: Patients with pulmonary hypertension (PH) experience distressing symptoms that can undermine quality of life (QoL) and treatment adherence. Complementary health approaches are known to help manage symptoms of chronic conditions and may have therapeutic benefits...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0359

    authors: Von Visger TT,Thrane SE,Klatt MD,Dabbs AD,Chlan LL,Tan A,Happ MB

    更新日期:2020-05-01 00:00:00

  • How do we interpret the answer "Neither" when physicians ask patients with cancer "Are you depressed or not?".

    abstract:OBJECTIVES:The aim of this study was to clarify how physicians should interpret the answer "neither" to the single-question interview, "Are you depressed or not?" PATIENTS AND METHODS:Two hundred fifty-one patients with cancer were studied. The patients were directly interviewed, choosing one answer among these three:...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2006.9.861

    authors: Ohno T,Noguchi W,Nakayama Y,Kato S,Tsujii H,Suzuki Y

    更新日期:2006-08-01 00:00:00

  • Improving knowledge and communication through an advance directives objective structured clinical examination.

    abstract::Many physicians and patients do not discuss care at the end of life and most practicing physicians have had little formal education concerning end-of-life discussions. To address this deficiency, our internal medicine residency faculty participated in the National End of Life Residency Education Project and implemente...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/10966210260499131

    authors: Aronson SG,Kirby RW

    更新日期:2002-12-01 00:00:00

  • Exploring Nonresponse Bias in the Department of Veterans Affairs' Bereaved Family Survey.

    abstract:BACKGROUND:Patients' and families' evaluations of health care, including palliative care, are widely used as performance measures. Survey scores may be affected by nonresponse bias, resulting in inaccurate performance evaluation. OBJECTIVES:Our aim was to examine nonresponse bias for the mailed version of the Departme...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2015.0050

    authors: Smith D,Kuzla N,Thorpe J,Scott L,Ersek M

    更新日期:2015-10-01 00:00:00

  • Improving access to palliative care through an innovative quality improvement initiative: an opportunity for pay-for-performance.

    abstract:BACKGROUND:Improving access to palliative care is an important priority for hospitals as they strive to provide the best care and quality of life for their patients. Even in hospitals with longstanding palliative care programs, only a small proportion of patients with life-threatening illnesses receive palliative care ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1089/jpm.2011.0301

    authors: Bernacki RE,Ko DN,Higgins P,Whitlock SN,Cullinan A,Wilson R,Jackson V,Dahlin C,Abrahm J,Mort E,Scheer KN,Block S,Billings JA

    更新日期:2012-02-01 00:00:00

  • Palliative medicine physician education in the United States: a historical review.

    abstract::In this review we discuss the history of Hospice and Palliative Medicine (HPM) physician education in the United States over the last 20 years, as there has been dramatic growth in our specialty during this time. A Medline literature search was completed and we surveyed leaders in the field of HPM education regarding ...

    journal_title:Journal of palliative medicine

    pub_type: 历史文章,杂志文章,评审

    doi:10.1089/jpm.2012.0436

    authors: Case AA,Orrange SM,Weissman DE

    更新日期:2013-03-01 00:00:00

  • Palliative Care in a Community-Based Serious-Illness Care Program.

    abstract:: Background: Although community-based serious-illness care (CBSC) is an innovative care model, it is unclear to what extent CBSC addresses palliative care needs, particularly for those patients near death. Objectives: To evaluat...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0174

    authors: Ernecoff NC,Hanson LC,Fox AL,Daaleman TP,Kistler CE

    更新日期:2020-05-01 00:00:00

  • Parental bereavement needs in the pediatric intensive care unit: review of available measures.

    abstract:BACKGROUND:Pediatric intensive care units (PICUs) are highly technological settings in which advanced care is used to restore health to critically ill children; however, they are also places where children die. Understanding the needs of parents bereaved in this setting is essential for better family care. OBJECTIVE:T...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2010.0453

    authors: Meert KL,Schim SM,Briller SH

    更新日期:2011-08-01 00:00:00

  • Jewish medical ethics and end-of-life care.

    abstract::While Judaism espouses the infinite value of human life, Judaism recognizes that all life is finite and, as such, its teachings are compatible with the principles of palliative medicine and end-of-life care as they are currently practiced. Jewish medical ethics as derived from Jewish law, has definitions for the four ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2004.7.558

    authors: Kinzbrunner BM

    更新日期:2004-08-01 00:00:00

  • Breaking Barriers: Prospective Study of a Cohort of Advanced Chronic Obstructive Pulmonary Disease Patients To Describe Their Survival and End-of-Life Palliative Care Requirements.

    abstract:BACKGROUND AND AIM:Consensus has been reached on the need to integrate palliative care in the follow-up examinations of chronic obstructive pulmonary disease (COPD) patients. We analyzed the survival from the initiation of follow-up by a palliative home care team (PHCT) and described the needs and end-of-life process. ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2018.0363

    authors: Gainza-Miranda D,Sanz-Peces EM,Alonso-Babarro A,Varela-Cerdeira M,Prados-Sánchez C,Vega-Aleman G,Rodriguez-Barrientos R,Polentinos-Castro E

    更新日期:2019-03-01 00:00:00

  • Research methods priorities in geriatric palliative medicine.

    abstract::Continuing the momentum of geriatric palliative medicine research achieved during the past decade requires a focus on research methods priorities that span the continuum of research from small pilot studies testing new interventions to large multisite studies evaluating implementation of proven interventions and model...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2013.9492

    authors: Aldridge Carlson MD

    更新日期:2013-08-01 00:00:00

  • Single-Center Experience Providing Palliative Care to Pediatric Patients with End-Stage Renal Disease.

    abstract:BACKGROUND:End-stage renal disease (ESRD) affects nearly 1400 new children each year in the United States. Morbidity and mortality rates remain high for pediatric patients with ESRD, including those that have received a renal transplant. OBJECTIVE:To better understand ESRD patients referred to palliative care, includi...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2016.0353

    authors: Keefer P,Lehmann K,Shanley M,Woloszyk T,Khang E,Luckritz K,Saul D

    更新日期:2017-08-01 00:00:00

  • Addition of methadone to another opioid in the management of moderate to severe cancer pain: a case series.

    abstract:BACKGROUND:Previous research has reported improved pain after adding methadone to another opioid, but did not quantify this benefit using a validated outcome measure. OBJECTIVE:To assess quantitatively the effectiveness of adding methadone to another opioid for moderate to severe cancer-related pain. DESIGN:All outpa...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2012.0335

    authors: Wallace E,Ridley J,Bryson J,Mak E,Zimmermann C

    更新日期:2013-03-01 00:00:00

  • Change in Food Intake Status of Terminally Ill Cancer Patients during Last Two Weeks of Life: A Continuous Observation.

    abstract:BACKGROUND:The oral food intake of terminally ill cancer patients is known to gradually decrease, but there are few reports about how oral intake changes around the terminal stage. It is important to clarify changes in oral food intake, as such changes affect the support and care of terminally ill cancer patients. OBJ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2015.0495

    authors: Ohno T,Tamura F,Kikutani T,Morita T,Sumi Y

    更新日期:2016-08-01 00:00:00

  • Palliative Radiotherapy Education for Hospice and Palliative Medicine Fellows: A National Needs Assessment.

    abstract:: Background: Insufficient knowledge of palliative radiotherapy (PRT) among hospice and palliative medicine (HPM) physicians is thought to be a barrier to the provision of high-quality palliative care. Objective: To assess the ne...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0118

    authors: Martin EJ,Jones JA

    更新日期:2020-02-01 00:00:00

  • Fundamentals of education: "Edu-Mentals".

    abstract::As new accreditation standards for health professions education increasingly require end-of-life (EOL) curriculum and performance-based assessment, health professions educators struggle to shift through the educational literature to find core principles, practical strategies, emerging trends, and on-line resources to ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/109662101750290263

    authors: Simpson DE,Biernat K

    更新日期:2001-07-01 00:00:00

  • Defining Provider-Prioritized Domains of Quality in Pediatric Home-Based Hospice and Palliative Care: A Study of the Ohio Pediatric Palliative Care and End-of-Life Network.

    abstract:BACKGROUND:In 2017, the Ohio Pediatric Palliative Care and End-of-Life Network (OPPEN) published nine domains of high-quality care for pediatric home-based hospice and palliative care (HBHPC). Eight domains established by the National Consensus Project (NCP) were validated for pediatric HBHPC, and a ninth domain of "Co...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2018.0056

    authors: Thienprayoon R,Alessandrini E,Frimpong-Manso M,Grossoehme D

    更新日期:2018-10-01 00:00:00

  • Evidence-based palliative care in the intensive care unit: a systematic review of interventions.

    abstract:BACKGROUND:Over the last 20 years, multiple interventions to better integrate palliative care and intensive care unit (ICU) care have been evaluated. This systematic review summarizes these studies and their outcomes. METHODS:We searched MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2013.0409

    authors: Aslakson R,Cheng J,Vollenweider D,Galusca D,Smith TJ,Pronovost PJ

    更新日期:2014-02-01 00:00:00

  • An Update: NIH Research Funding for Palliative Medicine, 2011-2015.

    abstract:BACKGROUND:The evidence base to support palliative care clinical practice is inadequate and opportunities to improve the palliative care evidence base remain despite the field's rapid growth. OBJECTIVE:To examine current NIH funding of palliative medicine research, changes since our 2013 report, and trends since our 2...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2017.0287

    authors: Brown E,Morrison RS,Gelfman LP

    更新日期:2018-02-01 00:00:00

  • How do we talk to the children? Child life consultation to support the children of seriously ill adult inpatients.

    abstract:BACKGROUND:Families with young children often struggle to talk about and cope with a parent's life-threatening illness and potential death. Adult interdisciplinary palliative medicine teams often feel unprepared to facilitate the open communication with these children that has been shown to reduce anxiety, depression, ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2012.0019

    authors: Sutter C,Reid T

    更新日期:2012-12-01 00:00:00

  • Barriers to hospice care and referrals: survey of physicians' knowledge, attitudes, and perceptions in a health maintenance organization.

    abstract:INTRODUCTION:Many proponents of hospice care believe that this service is underutilized. OBJECTIVE:To determine physicians' perceptions of hospice utilization and of their own hospice referral pattern; their perceived and actual knowledge of appropriate hospice referral diagnoses; and perceived barriers to hospice ref...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/1096621041349518

    authors: Brickner L,Scannell K,Marquet S,Ackerson L

    更新日期:2004-06-01 00:00:00

  • Percutaneous cervical cordotomy for the management of pain from cancer: a prospective review of 45 cases.

    abstract:BACKGROUND:Percutaneous cervical cordotomy (PCC) is a well recognized but infrequently performed procedure for the relief of unilateral intractable pain from malignancy. There is a paucity of data regarding efficacy and safety of PCC. OBJECTIVES:The study's objectives were to demonstrate the efficacy and safety of PCC...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2013.0027

    authors: Bain E,Hugel H,Sharma M

    更新日期:2013-08-01 00:00:00

  • Enhanced analgesia with opioid antagonist administration.

    abstract:BACKGROUND:Pain, not responsive to opioid analgesics, remains a problem for patients with chronic and cancer pain as well as their families, and clinicians. Opioid antagonists have various uses in pain and palliative care. Their use in the reversal of tolerance and hyperalgesia remains at the basic science level and ha...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2006.9.1250

    authors: Loitman JE

    更新日期:2006-12-01 00:00:00

  • Exploring Factors Contributing to Medication Errors with Opioids in Australian Specialist Palliative Care Inpatient Services: A Multi-Incident Analysis.

    abstract:BACKGROUND:Opioid errors have the potential to cause significant patient harm. These high-risk medications are used in high volumes in palliative care services to manage pain and other symptoms. Palliative patients are at greater risk of harm from opioid errors, as they are generally older and taking numerous medicatio...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2017.0578

    authors: Heneka N,Shaw T,Rowett D,Lapkin S,Phillips JL

    更新日期:2018-06-01 00:00:00

  • Family Caregiver Perspectives on End-of-Life Dreams and Visions during Bereavement: A Mixed Methods Approach.

    abstract:: Background: End-of-life dreams and visions (ELDVs) are prevalent experiences that provide comfort and meaning to dying individuals. Limited research has examined the impact of ELDVs on the bereaved. Objective: This study aimed ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0093

    authors: Grant PC,Depner RM,Levy K,LaFever SM,Tenzek KE,Wright ST,Kerr CW

    更新日期:2020-01-01 00:00:00

  • Methadone as the Initial Long-Acting Opioid in Children with Advanced Cancer.

    abstract:BACKGROUND:Methadone is an attractive medication for treating children with advanced cancer with pain as it is the only long-acting opioid available as a liquid. However, it is not frequently used due to concerns about potential toxicities and side effects. OBJECTIVE:Evaluate the efficacy and safety of methadone as th...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2017.0712

    authors: Madden K,Mills S,Dibaj S,Williams JL,Liu D,Bruera E

    更新日期:2018-09-01 00:00:00

  • Development of an Assessment to Examine Training of the Hospice Primary Caregiver.

    abstract:BACKGROUND:Key to high-quality care of dying hospice patients at home is whether the hospice provides adequate training so the caregiver can safely care for the patient. OBJECTIVE:The study objective was to develop and validate a survey of hospice training for caregivers to ensure safe, high-quality care in the home s...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2015.0185

    authors: DiBiasio EL,Teno JM,Clark MA,Spence C,Casarett D

    更新日期:2016-06-01 00:00:00

  • Description of Continuous Palliative Sedation Practices in a Large Health Region and Comparison with Clinical Practice Guidelines.

    abstract:: Background: Published reports of continuous palliative sedation therapy (CPST) suggest heterogeneity in practice. There is a paucity of reports that compare practice with clinical guidelines. Objectives: To assess adherence of ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2018.0372

    authors: Abdul-Razzak A,Lemieux L,Snyman M,Perez G,Sinnarajah A

    更新日期:2019-09-01 00:00:00

  • Countrywide Situational Analysis of Palliative Care in Bolivia.

    abstract:: Background: There are substantial disparities in distribution of palliative care (PC) services within Latin America, with Bolivia historically lagging behind neighboring countries in PC metrics. Comprehensive data on PC in Bolivia were last collected in 2012 through the La...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2020.0169

    authors: Judkins J,Alhalel J,Hauser J,Pastrana T

    更新日期:2020-09-21 00:00:00

  • Factors Associated with Length of Stay at Home in the Final Month of Life among Advanced Cancer Patients: A Retrospective Chart Review.

    abstract:BACKGROUND:Living at home is an important factor for maintaining high quality of life among patients. Many studies have discussed parameters associated with place of death, but no studies have yet clarified which factors influence the length of stay at home during the end of life. OBJECTIVE:The aim of this study was t...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2016.0455

    authors: Otsuka M

    更新日期:2017-08-01 00:00:00