PURPOSE: The objective of this study was to evaluate cost-reduction efficacy of a palliative care unit (PCU) by analyzing medical expenses of terminal cancer patients. METHODS: Hospital bills and medical records of 656 patients who died of cancer from January to December 2007 at one university hospital in Seoul were analyzed. RESULTS: Of the total 656 patients, 126 died in the PCU. Compared to non-PCU patients, PCU patients were more likely to permit do-not-resuscitate (DNR), visit the emergency room (ER), and receive palliative chemotherapy (P < 0.001, P = 0.045, P = 0.002). The non-PCU patients were admitted to the intensive care unit (ICU), used a ventilator, and received hemodialysis more often (P < 0.001, P < 0.001, P < 0.001). Total medical cost per all patients within 6 months of death averaged $27,863. There was a significant difference in medical costs starting at 2 months before death between PCU and non-PCU patients. The medical cost of the PCU group was 32.8% lower 1 month before death and 33.0% lower 2 months before death than the non-PCU group (P < 0.001, P < 0.001). Patients using PCU services, those with solid cancers, and those with less than a high school education paid lower medical expenses (P < 0.05) CONCLUSION: Cost savings of the PCU were verified. It was also determined that specific factors were tied to increased medical expenses during the last 6 months of life. If these parameters are controlled properly, additional cost savings, associated with palliative care could be realized.
PURPOSE: The objective of this study was to evaluate cost-reduction efficacy of a palliative care unit (PCU) by analyzing medical expenses of terminal cancerpatients. METHODS: Hospital bills and medical records of 656 patients who died of cancer from January to December 2007 at one university hospital in Seoul were analyzed. RESULTS: Of the total 656 patients, 126 died in the PCU. Compared to non-PCU patients, PCU patients were more likely to permit do-not-resuscitate (DNR), visit the emergency room (ER), and receive palliative chemotherapy (P < 0.001, P = 0.045, P = 0.002). The non-PCU patients were admitted to the intensive care unit (ICU), used a ventilator, and received hemodialysis more often (P < 0.001, P < 0.001, P < 0.001). Total medical cost per all patients within 6 months of death averaged $27,863. There was a significant difference in medical costs starting at 2 months before death between PCU and non-PCU patients. The medical cost of the PCU group was 32.8% lower 1 month before death and 33.0% lower 2 months before death than the non-PCU group (P < 0.001, P < 0.001). Patients using PCU services, those with solid cancers, and those with less than a high school education paid lower medical expenses (P < 0.05) CONCLUSION: Cost savings of the PCU were verified. It was also determined that specific factors were tied to increased medical expenses during the last 6 months of life. If these parameters are controlled properly, additional cost savings, associated with palliative care could be realized.
Authors: Paige E Sheridan; Wendi G LeBrett; Daniel P Triplett; Eric J Roeland; Andrew R Bruggeman; Heidi N Yeung; James D Murphy Journal: Am J Hosp Palliat Care Date: 2021-01-11 Impact factor: 2.090