TY - JOUR
T1 - Palliative care inpatient service in a comprehensive cancer center
T2 - Clinical and financial outcomes
AU - Elsayem, Ahmed
AU - Swint, Kay
AU - Fisch, Michael J.
AU - Palmer, J. Lynn
AU - Ready, Suresh
AU - Walker, Paul
AU - Zhukovsky, Donna
AU - Knight, Patti
AU - Bruera, Eduardo
PY - 2004
Y1 - 2004
N2 - Purpose: Inpatient palliative care units are unavailable in most cancer centers and tertiary hospitals. The purpose of this article is to review the outcomes of the first 344 admissions to the Palliative Care Inpatient Service (PCIS) at our comprehensive cancer center. Patients and Methods: We retrospectively reviewed our computerized database for clinical and demographic information, length of stay, and hospital billing during the first year of the service's operation. Results: Three hundred twenty patients were admitted during the study period. Their median age was 57 years. The main cancer diagnoses were thoracic or head and neck (44%), gastrointestinal (25%), and hematologic malignancy (8%). The main referral symptoms were pain (44%), nausea (41%), fatigue (39%), and dyspnea (38%). The median length of stay in the PCIS was 7 days (range, 1 to 58 days). Fifty-nine patients died while in the PCIS. However, the overall hospital mortality rate was not increased compared with that in the year before the establishment of the PCIS (3.58% v 3.59%). The mean reimbursement rate for all palliative care charges was approximately 57%, and the mean daily charges in the PCIS were 38% lower than the mean daily charges for the rest of the hospital. Symptom intensity data showed severe distress on admission and significant improvement in the main target symptoms. Most patients were discharged to a hospice. Conclusion: The PCIS has been accepted in our tertiary cancer center on the basis of its clinical utility and financial viability.
AB - Purpose: Inpatient palliative care units are unavailable in most cancer centers and tertiary hospitals. The purpose of this article is to review the outcomes of the first 344 admissions to the Palliative Care Inpatient Service (PCIS) at our comprehensive cancer center. Patients and Methods: We retrospectively reviewed our computerized database for clinical and demographic information, length of stay, and hospital billing during the first year of the service's operation. Results: Three hundred twenty patients were admitted during the study period. Their median age was 57 years. The main cancer diagnoses were thoracic or head and neck (44%), gastrointestinal (25%), and hematologic malignancy (8%). The main referral symptoms were pain (44%), nausea (41%), fatigue (39%), and dyspnea (38%). The median length of stay in the PCIS was 7 days (range, 1 to 58 days). Fifty-nine patients died while in the PCIS. However, the overall hospital mortality rate was not increased compared with that in the year before the establishment of the PCIS (3.58% v 3.59%). The mean reimbursement rate for all palliative care charges was approximately 57%, and the mean daily charges in the PCIS were 38% lower than the mean daily charges for the rest of the hospital. Symptom intensity data showed severe distress on admission and significant improvement in the main target symptoms. Most patients were discharged to a hospice. Conclusion: The PCIS has been accepted in our tertiary cancer center on the basis of its clinical utility and financial viability.
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U2 - 10.1200/JCO.2004.11.003
DO - 10.1200/JCO.2004.11.003
M3 - Review article
C2 - 15143094
AN - SCOPUS:3042741114
SN - 0732-183X
VL - 22
SP - 2008
EP - 2014
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 10
ER -