Palliative Care and Improving Quality of Life

Palliative Care: Quality of Life for Cancer Patients

What is palliative care?

Palliative care is specialized medical care that improves quality of life for patients and families by focusing on relief from pain, stress, and other symptoms of treatment for a serious disease such as cancer. It is appropriate at any age and any stage and can be provided alongside curative treatment. It is delivered by trained specialists who work together with doctors and nurses in a team-based approach that focuses on the patients’ needs, explains treatment options and gives patients and their families a voice in realizing their treatment goals. Palliative care treats the person, not just the disease.

Patients and doctors want palliative care

People facing serious illness want the types of services that palliative care provides –and they expect today’s hospitals to deliver. Palliative care teams provide:

• Time to devote to intensive family meetings and patient/family counseling.

• Expertise in managing complex physical and emotional symptoms such as pain, shortness of breath, depression, and nausea.

• Communication & support for resolving family/patient/physician questions concerning goals of care.

• Coordination of care transitions across health care settings.

An overwhelming majority of doctors (96%) support palliative care. Additionally, once informed about palliative care, 92% of consumers say these services should be available for seriously ill patients and their families.

Maximizing hospital efficiency and lowering costs

• A study published in 2008 in the Archives of Internal Medicine found that hospital palliative care consultation teams are associated with significant hospital savings. The study concluded that palliative care patients discharged alive had an adjusted net savings of $1696 in direct costs per admission and $279 in direct costs per day, and palliative care patients who died in the hospital had an adjusted net savings of $4908 in direct costs per admission and $374 in direct costs per day.  This means savings of more than $1.3 million for a 300-bed community hospital and more than $2.5 million for the average academic medical center.

• A 2015 study published in Health Services Research showed significant cost reductions at 5 hospitals in the Dallas-Fort Worth, Texas area. The study found that palliative care in the first 10 days of admission resulted in $9,689 savings for patients who died in the hospital, and $2,696 for patients discharged alive.

• A 2011 study published in Health Affairs demonstrated that hospital based palliative care teams create efficiencies that deliver significant cost savings. Provision of palliative care consultations to Medicaid patients at four New York state hospitals resulted in almost $7,000 of savings in hospital costs per admission, and these patients spent less time in intensive care and were less likely to die in the intensive care unit. The study’s estimated reduction in New York Medicaid hospital spending, if all large hospitals were to have a palliative care team, was between $84 and $252 million per year.

• Palliative care reduces long lengths of stay, high costs per day, and the often futile high utilization of critical care and other hospital resources.

Palliative care can add more days to patients’ lives and more life to their days

• Studies have shown coordinating patient care and treating pain and symptoms leads to increased patient and family satisfaction and decreases the time spent in intensive care units and the likelihood patients will be readmitted.

• One 2010 study published in the New England Journal of Medicine found that early palliative care provided alongside cancer treatment resulted in patients living longer. The study examined introducing routine palliative care evaluations and ongoing support for patients newly diagnosed with lung cancer. The results were that patients felt better, were less depressed, were less likely to die in the hospital, and were less likely to be in the hospital in their last month of life. Patients who got palliative care at the same time as their cancer treatment lived nearly 3 months longer than similar patients getting only cancer care but not receiving palliative care.

• Other studies have shown that when palliative care teams work together with oncologists, patients are able to remain at home – they don’t end up in the emergency room and hospital with pain and symptom crises. As a result, they go through fewer unnecessary tests and procedures.

Palliative care programs provide higher-quality care for patients and a better bottom line for hospitals.