Palliative Care at a Palatable Cost

Specialty hospital units offer better, more affordable care for terminally ill

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WEDNESDAY, Nov. 5, 2003 (HealthDayNews) -- Hospital-based specialty palliative care units for terminally ill patients provide better care at lower costs, says a Virginia Commonwealth University study (VCU).

This is the first study to compare the cost of caring for these kinds of patients in a palliative care unit compared to a regular hospital setting. The authors say their findings make a strong case for treating patients with complex medical conditions in a specialty hospital unit.

The study included 237 patients with such conditions as cancer, AIDS, vascular diseases and organ failure. All were admitted to the Thomas Palliative Care Unit of the VCU Medical Center during its first six months of operation.

Of those patients, 123 were transferred to the palliative care unit from either intensive care units or other units at the VCU Medical Center. Among those patients, the charges and costs per day were reduced by 66 percent overall and 74 percent in the case of medications and diagnostic tests when they were moved to the palliative care unit.

The researchers also analyzed the costs for 38 patients who died in the palliative care unit compared to 38 similar patients who died in other VCU Medical Center units. The cost for the patients in the palliative care unit was 59 percent lower per patient -- $2,172 versus $5,304.

"End-of-life care suffers from lack of quality care and high costs," lead author Dr. Thomas J. Smith, chairman of VCU's division of hematology/oncology and a palliative care expert, says in a prepared statement.

"But medically appropriate care and caring for people at the end of life can be done effectively in the U.S. care system, and we can afford it. It will require medical professionals to be frank about the possible goals of care, develop standard plans based on the evidence and assign only caregivers who are good a palliative care and interested in it," Smith says.

"Patients want to be free of pain, independent and at home, if at all possible. But when patients are hospitalized at the end of life, they can received excellent symptom control in a caring environment. Over 90 percent of our patients have excellent symptom control and are very pleased with their care. An added benefit is that the total cost of care can be reduced by almost half, which saves society money," Smith says.

The study appears in the October issue of the Journal of Palliative Medicine.

More information

Here's where you can learn more about palliative care.

SOURCE: Virginia Commonwealth University, news release, October 2003


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