Literature DB >> 15143094

Palliative care inpatient service in a comprehensive cancer center: clinical and financial outcomes.

Ahmed Elsayem1, Kay Swint, Michael J Fisch, J Lynn Palmer, Suresh Reddy, Paul Walker, Donna Zhukovsky, Patti Knight, Eduardo Bruera.   

Abstract

PURPOSE: Inpatient palliative care units are unavailable in most cancer centers and tertiary hospitals. The purpose of this article is to review the outcomes of the first 344 admissions to the Palliative Care Inpatient Service (PCIS) at our comprehensive cancer center. PATIENTS AND METHODS: We retrospectively reviewed our computerized database for clinical and demographic information, length of stay, and hospital billing during the first year of the service's operation.
RESULTS: Three hundred twenty patients were admitted during the study period. Their median age was 57 years. The main cancer diagnoses were thoracic or head and neck (44%), gastrointestinal (25%), and hematologic malignancy (8%). The main referral symptoms were pain (44%), nausea (41%), fatigue (39%), and dyspnea (38%). The median length of stay in the PCIS was 7 days (range, 1 to 58 days). Fifty-nine patients died while in the PCIS. However, the overall hospital mortality rate was not increased compared with that in the year before the establishment of the PCIS (3.58% v 3.59%). The mean reimbursement rate for all palliative care charges was approximately 57%, and the mean daily charges in the PCIS were 38% lower than the mean daily charges for the rest of the hospital. Symptom intensity data showed severe distress on admission and significant improvement in the main target symptoms. Most patients were discharged to a hospice.
CONCLUSION: The PCIS has been accepted in our tertiary cancer center on the basis of its clinical utility and financial viability.

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Year:  2004        PMID: 15143094     DOI: 10.1200/JCO.2004.11.003

Source DB:  PubMed          Journal:  J Clin Oncol        ISSN: 0732-183X            Impact factor:   44.544


  55 in total

1.  Development and cross-validation of the in-hospital mortality prediction in advanced cancer patients score: a preliminary study.

Authors:  David Hui; Kelly Kilgore; Bryan Fellman; Diana Urbauer; Stacy Hall; Julieta Fajardo; Wadih Rhondali; Jung Hun Kang; Egidio Del Fabbro; Donna Zhukovsky; Eduardo Bruera
Journal:  J Palliat Med       Date:  2012-06-04       Impact factor: 2.947

2.  Increased access to palliative care and hospice services: opportunities to improve value in health care.

Authors:  Diane E Meier
Journal:  Milbank Q       Date:  2011-09       Impact factor: 4.911

3.  Palliative care is a key component of daily practice in oncology: descriptive study of hospitalisation events at an oncology treatment centre.

Authors:  Enrique Espinosa; Alvaro Pinto; Pilar Zamora; Jaime Feliu; Beatriz Martínez; Manuel González Barón
Journal:  Support Care Cancer       Date:  2010-05-28       Impact factor: 3.603

4.  Better care, better bottom line for hospitals.

Authors:  R Sean Morrison
Journal:  Medscape J Med       Date:  2008-12-05

5.  Routine symptom assessment: good for practice and good for business.

Authors:  Eduardo Bruera
Journal:  Support Care Cancer       Date:  2008-04-02       Impact factor: 3.603

6.  Discharge outcomes and survival of patients with advanced cancer admitted to an acute palliative care unit at a comprehensive cancer center.

Authors:  David Hui; Ahmed Elsayem; Shana Palla; Maxine De La Cruz; Zhijun Li; Sriram Yennurajalingam; Eduardo Bruera
Journal:  J Palliat Med       Date:  2010-01       Impact factor: 2.947

Review 7.  Bringing palliative care to a Canadian cancer center: the palliative care program at Princess Margaret Hospital.

Authors:  Camilla Zimmermann; Dori Seccareccia; Allyson Clarke; David Warr; Gary Rodin
Journal:  Support Care Cancer       Date:  2006-06-27       Impact factor: 3.603

8.  Characteristics and outcomes of advanced cancer patients who miss outpatient supportive care consult appointments.

Authors:  Marvin Omar Delgado Guay; Marvin Omar Delgado Guay; Silvia Tanzi; Maria Teresa San Miguel Arregui; Maria Teresa San Miguel Arregui; Gary Chisholm; Maxine G De la Cruz; Maxine de la Cruz; Eduardo Bruera
Journal:  Support Care Cancer       Date:  2014-04-26       Impact factor: 3.603

9.  Access to palliative care among patients treated at a comprehensive cancer center.

Authors:  David Hui; Sun-Hyun Kim; Jung Hye Kwon; Kimberson Cochien Tanco; Tao Zhang; Jung Hun Kang; Wadih Rhondali; Gary Chisholm; Eduardo Bruera
Journal:  Oncologist       Date:  2012-12-07

Review 10.  Palliative care reduces morbidity and mortality in cancer.

Authors:  Gabrielle B Rocque; James F Cleary
Journal:  Nat Rev Clin Oncol       Date:  2012-12-18       Impact factor: 66.675

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