Sage Journals: Discover world-class research

Abstract

Introduction: Delayed discussion of a patient’s code status can lead to shortsighted care plans that increase hospital length of stay (LOS) and costs. Methods: Retrospective study compared intensive care unit (ICU) patients who accepted verses rejected palliation and examined the relationships between 5 predictor variables with the outcome variables ICU LOS and total hospital LOS, and total direct and variable hospital cost. Results: A significant number of patients who accepted palliative care agreed to a hospice referral or expired in the hospital. The relationships between days until a family conference, do-not-resuscitate (DNR) order, and the number of invasive procedures were significant. Conclusions: The amount of time that expires until the issue of code status was settled to clearly related to utilization of hospital resources.

Keywords

palliation health care cost code status hospice

Get full access to this article

View all access options for this article.

References

Morrison RS , Maroney-Galin C. , Kralovec PD , Meier DE The growth of palliative care programs in United States hospitals. J Palliat Med. 2005;8(6):1127-1134.

Support The SUPPORT Principal Investigators.A controlled trial to improve care for seriously ill hospitalized patients: the study to understand prognoses and preferences for outcomes and risks of treatment. JAMA. 1995;274(20):1591-1598.

Wright AA , Zhang B. , Ray A. , et al. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA. 2008; 300(14):1665-1673.

Zhang B. , Wright AA , Huskamp HA , et al. Health care costs in the last week of life. Arch Intern Med. 2009;169(5):480-488.

Cowan JD Hospital charges for a community inpatient palliative care program. Am J Hosp Palliat Med. 2004;21(3):177-190.

Penrod JD , Deb P. , Luhrs C. , et al. Cost and utilization outcomes of patients receiving hospital-based palliative care consultation. J Palliat Med. 2006;9(4):855-860.

Meier D. Palliative care as a quality improvement strategy for advanced, chronic illness . JHQ. 2005;27(1):33-38.

Morrison RS , Penrod JD , Cassel JB , et al. Cost savings associated with US hospital palliative care consultation programs. Arch Intern Med. 2008;168(16):1783-1790.

Kuehn BM Hospitals embrace palliative care. JAMA. 2007 ; 298(11):1263-1265.

10.

De Jonge KE , Sulmasy DP , Gold KG , et al. The timing of Do-Not-Resuscitate orders and hospital costs. J Gen Intern Med. 1999 ;14(3):190-192.

11.

Shepardson LB , Justice AC , Harper DL , Rosenthal GE Associations between the use of do-not-resuscitate orders and length of stay in patients with stroke. Med Care . 1998;36(8 suppl):AS57-AS67.

12.

Zoch TW , Desbiens NA , DeStefano F. , Stueland DT , Layde PM Short- and long-term survival after cardiopulmonary resuscitation. Arch Intern Med. 2000;160(13):1969-1973.

The Triad That Matters: Palliative Medicine,Code Status,and Health Care Costs

Abstract

Keywords

Get full access to this article

References