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- W2017384018 abstract "1.Discuss the evidence that supports bending the cost curve with concurrent care.2.Recognize that the evidence suggests such treatments will enhance quality and quantity of life, rather than the reverse.3.Discuss how to take practical steps to incorporate some new best practices into clinical care guidelines and treatments. The cost of medical care is rising at an unsustainable rate due to new and costly advances, more people, more aging people, people living longer with chronic illnesses, and the way we deliver health care, some of which is under our control. There are only a few ways to bend the rising cost curve downwards to a sustainable rate: reduce costs, populations covered, or services or some combination of these options. Reducing costs during the last phases of life may be one way to honor realistic choices, enhance the living experience, reduce hospitalization, and increase the number of people who have adequate home care. Multiple studies have shown that concurrent palliative care with regular care may increase rather than decrease lifespan, improve symptom management and communication, and allow more people to stay at home towards the end of life. By reducing intensive care such as chemotherapy and hospitalization, such concurrent care may actually reduce costs as well as improve care. Several changes in healthcare are predictable for the near future. Hospice will increasingly be used for such care as witnessed by the roll-out of multiple concurrent care programs such as the Compassionate Care Program of Aetna. New “checklist” approaches to clinical care pathways in advanced cancer will ensure that advanced directive discussions are held earlier, hospice is introduced early as a best practice, and chemotherapy will be used less towards the end of life. Such programs are associated with equal or better survival, increased hospice use and duration, and 35% lower costs. We will review the evidence base for concurrent care as a way to bend the cost curve that also improves care, and give specific examples of how practitioners can adopt new best practices, including innovative programs of advanced care that reduce health system fragmentation and costs." @default.
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- W2017384018 date "2012-02-01" @default.
- W2017384018 modified "2023-09-26" @default.
- W2017384018 title "Bending the Cost Curve: A Lively Panel Discussion" @default.
- W2017384018 doi "https://doi.org/10.1016/j.jpainsymman.2011.12.027" @default.
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