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Dr. Sean Morrison said bringing together doctors, nurses, chaplains and social workers to talk through treatment options with patients and their families makes sense not only for the patient with end-stage pancreatic cancer but also for the one in the early stages of a relatively curable leukemia.
And now, Dr. Morrison said, data suggests not only improved outcomes for patients, but potentially thousands of dollars' worth of savings per hospital visit and tens or hundreds of millions of dollars' worth of potential savings state-wide.
His study in the journal Health Affairs compared the treatment of hundreds of patients at four hospitals across New York State. The main savings come from shortening hospital stays and keeping people out of the Intensive Care Units.
"What we found is that when patients received palliative care plus usual care, it resulted in somewhere between $4,000 and $7,500 per admission to the hospital," said Morrison, an internist, geriatrician and palliative care specialist at Mt. Sinai Medical Center.
He estimated that could save the New York Medicaid program up to $250 million, if applied to all hospitals with 150 beds or more.
Morrison said about 80 percent of hospitals already have palliative care teams, but that doesn’t mean widespread savings would be easy to come by because there’s a wide variation in how effective these teams are.
He also said said there's much resistance to expanding palliative care because hospitals can’t always bill Medicaid or insurers for it, and many doctors associate it with giving up on patients.
Fred Mogul has been covering healthcare and medicine for WNYC since 2002. His beat takes him to hospitals, community clinics, doctors offices, health agencies, public schools and research labs across the metropolitan area. His work has appeared on NPR and in the New York Times, Time magazine and Philadelphia Inquirer, among others.
Comments [2]
Dr. Morrison presents important cost information about the value of providing palliative care to patients with advanced illness. Another landmark study published this summer showed that patients who received palliative care at the time of diagnosis of advanced cancer lived longer, perhaps because their symptoms were treated more effectively. Because palliative care is so important for high quality care, New York State recently passed a law called the Palliative Care Information Act which requires doctors and nurse practitioners to give palliative care information to their patients with serious advanced illness.
Dr. Morrison is right about palliative care’s benefits to patients, families and hospitals. Simply put, palliative care matches patient wishes to treatment goals, and reduces suffering. Palliative care may be right for someone who suffers from pain or other symptoms due to a serious illness such as cancer, cardiac disease, respiratory disease, kidney failure, Alzheimer’s, AIDS, Amyotrophic Lateral Sclerosis (ALS) and multiple sclerosis. Palliative care can be provided at any stage of illness and along with treatment meant to cure. Good information sites for the general public are getpalliativecare.org and healthcarechaplaincy.org and for health care professionals capc.org.
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