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- W2572075204 abstract "•Learn about the potential future impacts of effective palliative health services interventions.•Learn about the applications of a powerful simulating model for projecting changes over time in end-of-life populations. A 2014 Institute of Medicine report concluded that broad improvements in end-of-life care are within reach. However, many currently available evidence-based palliative health services interventions have not been implemented on a large scale. Informed by our recent systematic review of 124 RCTs of palliative health services interventions from 2001 to 2015, we projected changes from 2016 to 2040 in health care costs, quality of life, and mortality resulting from the implementation of a palliative care team (PCT) for cancer patients and palliative case management (CM) for CHF patients. The Future Elderly Model is a microsimulation model derived from the Health and Retirement Study and Medicare data that projects the health status, quality of life, and economic outcomes of the US adults over age 50. We informed the model with parameters from RCTs identified in our systematic review. From 2016 to 2040 in the absence of any intervention, projections show increases in life expectancy and societal health care costs, and worsening pain, depression, and ADL difficulties. The PCT intervention directly reduced depression in cancer patients by 75.6% (sensitivity analysis, 70.6%-80.4%) and the PCM intervention directly reduced average ADL difficulties in CHF patients by 33.7% (19.4%, 37.1%). Both interventions reduced per capita societal health care costs, increased QALYs, and reduced mortality. The PCT intervention reduced societal health care costs by $103 billion ($95.4 billion, $109 billion). In the absence of changes in current practices, cost and quality of life outcomes at the end of life in cancer and CHF patients are projected to worsen over time. Palliative health services interventions have the potential to positively impact these outcomes over time." @default.
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- W2572075204 date "2017-02-01" @default.
- W2572075204 modified "2023-09-30" @default.
- W2572075204 title "Projecting the Impact of Implementing Palliative Care for Older Adults: What Does the Evidence Support? (FR461C)" @default.
- W2572075204 doi "https://doi.org/10.1016/j.jpainsymman.2016.12.151" @default.
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