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• W2894981215 abstract "SESSION TITLE: Electronic Top Posters SESSION TYPE: Original Inv Poster Discussion PRESENTED ON: 10/08/2018 01:15 PM - 02:15 PM PURPOSE: We hypothesized that early palliative care and hospice care intervention would reduce the length of stay and would result in decreased direct cost among the patients admitted either to medical/surgical ward or the Intensive Care Unit towards the end of life. METHODS: We conducted a retrospective chart review of 797 patients admitted to two hospitals between January 2015 and December 2016, all of whom were either discharged to hospice or expired after being transitioned to Comfort Measure Only (CMO) status.We compiled data including demographic information, medical comorbidities, characteristics of hospital stay, end of life planning and direct cost among patients who either received both palliative care consult and hospice consult versus no palliative care consult and no hospice consult. Statistical analysis was performed using Chi-square analysis for categorical variables and independent samples t-test for continuous variables, using STATA version 11, with p < 0.05 set as statistically significant. Regression analysis was performed to assess the effect of timing of palliative care consult on direct cost and length of hospital stay. RESULTS: Of the 584 patients analyzed thus far 52% had both palliative care and hospice consults versus 13% with neither service consulted (p < 0.0001). The presence of palliative care consult correlated with a higher incidence of hospice consults (p < 0.0001). The median direct cost among the two groups was $15,707.33 versus $24,394.79 respectively (p 0.001). There was no significant difference in demographic information or medical comorbidities between the two groups. Analysis of the timing of the palliative care consult in relation to the length of hospital stay revealed a significant increase in cost (an increase of $7,248.05 per patient; p <0.001) if palliative care consult was placed after the third hospital day. Similarly, an increase in the length of stay by 3.3 days (p <0.001) was also noted among the group where palliative care consults were done after 3 days of admission. CONCLUSIONS: Among patients with similar comorbidities and demographics, joint palliative care and hospice consults done at any point during hospital stay was associated with a decrease in direct cost. Palliative care consult alone, if performed within three days of admission, decreased length of hospital stay and the direct cost. CLINICAL IMPLICATIONS: Palliative care consult done by the third day of hospitalization significantly decreased length of hospital stay and direct cost among terminally ill patients who eventually reached comfort measure only (CMO) status or were discharged to hospice facilities. Presence of palliative care consult also resulted in a higher number of hospice consults in this patient population.Joint palliative and hospice consult done at any point during the hospital stay resulted in decrease in the direct cost. DISCLOSURES: No relevant relationships by YAHYA AHMAD, source=Web Response No relevant relationships by Sohaib Ansari, source=Web Response No relevant relationships by Kanwal Anwar, source=Web Response No relevant relationships by Salma Batool-Anwar, source=Web Response No relevant relationships by David Cardona Estrada, source=Web Response No relevant relationships by Kevin McDonald, source=Web Response No relevant relationships by Ashish Rai, source=Web Response No relevant relationships by Coleen Reid, source=Admin input No relevant relationships by Elizabeth Stevenson, source=Web Response" @default.
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• W2894981215 date "2018-10-01" @default.
• W2894981215 modified "2023-09-25" @default.
• W2894981215 title "DOES EARLY PALLIATIVE CARE CONSULTATION DECREASE LENGTH OF STAY AND DIRECT COST AMONG TERMINALLY ILL PATIENTS? A MULTICENTER STUDY" @default.
• W2894981215 doi "https://doi.org/10.1016/j.chest.2018.08.724" @default.
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