Palliative Care Consultation in the Intensive Care Unit Reduces Hospital Costs: A Cost-Analysis.

IF 1.3 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES Journal of Palliative Care Pub Date : 2025-01-01 Epub Date: 2022-04-26 DOI:10.1177/08258597221095986
Tong Han Chung, Linh K Nguyen, Lincy S Lal, J Michael Swint, Yen-Chi L Le, Kathleen R Hanley, Efrain Siller, Cheryl M Chanaud
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Abstract

Background: Palliative care aims to improve or maintain quality of life for patients with life-limiting or life-threatening diseases. Limited research shows that palliative care is associated with reduced intensive care unit length of stay and use of high-cost resources.

Methods: This was an observational, non-experimental comparison group study on all patients 18 years or older admitted to any intensive care unit (ICU) at Memorial Hermann - Texas Medical Center for 7 to 30 days from August 2013 to December 2015. Length of stay (LOS) and hospital costs were compared between the treatment group of patients with palliative care in the ICU and the control group of patients with usual care in the ICU. To adjust for confounding of the palliative care consultation on LOS and hospital cost, an inverse probability of treatment weighted method was conducted. Generalized linear models using gamma distribution and log link were estimated. All costs were converted to 2015 US dollars.

Results: Mean LOS was 13 days and mean total hospital costs were USD 58,378. In adjusted and weighted analysis, LOS for the treatment group was 8% longer compared to the control group. The mean total hospital cost was estimated to decrease by 21% for the treatment group versus the control group. We found a reduction of USD 33,783 in hospital costs per patient who died in the hospital and reduction of USD 9113 per patient discharged alive.

Conclusion: Palliative care consultation was associated with a reduction in the total cost of hospital care for patients with life-limiting or life-threatening diseases.

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重症监护室的姑息治疗咨询降低了医院成本:成本分析。
背景姑息治疗旨在改善或维持限制生命或危及生命的疾病患者的生活质量。有限的研究表明,姑息治疗与减少重症监护室的住院时间和使用高成本资源有关。方法本研究是一项观察性、非实验性对照组研究,对象为2013年8月至2015年12月在赫尔曼纪念得克萨斯医疗中心任何重症监护室(ICU)入住7至30天的所有18岁或以上患者。比较了在ICU接受姑息治疗的患者治疗组和在ICU接受常规治疗的患者对照组的住院时间(LOS)和住院费用。为了调整姑息治疗咨询对服务水平和住院费用的混淆,采用了治疗加权逆概率法。使用伽马分布和对数链接对广义线性模型进行了估计。所有费用均转换为2015年美元。结果平均LOS为13天,平均总住院费用为58378美元。在调整和加权分析中,治疗组的LOS比对照组长8%。与对照组相比,治疗组的平均总住院费用估计减少了21%。我们发现,每位在医院死亡的患者的住院费用减少了33783美元,每位活着出院的患者的费用减少了9113美元。结论姑息治疗咨询与降低限制生命或危及生命的疾病患者的医院护理总成本有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Palliative Care
Journal of Palliative Care 医学-卫生保健
CiteScore
3.20
自引率
5.90%
发文量
63
审稿时长
>12 weeks
期刊介绍: The Journal of Palliative Care is a quarterly, peer-reviewed, international and interdisciplinary forum for practical, critical thought on palliative care and palliative medicine. JPC publishes high-quality original research, opinion papers/commentaries, narrative and humanities works, case reports/case series, and reports on international activities and comparative palliative care.
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