@article{c2b0fc160b2043ce9b1a0b698d20abdd,
title = "Palliative care teams' cost-saving effect is larger for cancer patients with higher numbers of comorbidities",
abstract = "Patients with multiple serious conditions account for a high proportion of health care spending. Such spending is projected to continue to grow substantially as a result of increased insurance eligibility, the ever-rising cost of care, the continued use of nonbeneficial high-intensity treatments at the end of life, and demographic changes. We evaluated the impact of palliative care consultation on hospital costs for adults with advanced cancer, excluding those with dementia. We found that compared to usual care, the receipt of a palliative care consultation within two days of admission was associated with 22 percent lower costs for patients with a comorbidity score of 2-3 and with 32 percent lower costs for those with a score of 4 or higher. Earlier consultation was also found to be systematically associated with a larger cost-saving effect for all subsamples defined by multimorbidity. Given ongoing workforce shortages, targeting early specialist palliative care to hospitalized patients with advanced cancer and higher numbers of serious concurrent conditions could improve care while complementing strategies to curb the growth of health spending.",
author = "Peter May and Garrido, {Melissa M.} and Cassel, {J. Brian} and Kelley, {Amy S.} and Meier, {Diane E.} and Charles Normand and Lee Stefanis and Smith, {Thomas J.} and Morrison, {R. Sean}",
note = "Funding Information: An early version of these results was presented at the Annual Assembly of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association, Philadelphia, Pennsylvania, February 26, 2015. The study was funded by the National Cancer Institute (NCI) and the National Institute of Nursing Research (Project No. 5R01CA116227-04). The study sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. All authors are independent of the study sponsors. Peter May is sponsored by a health economics fellowship from the Health Research Board of Ireland and by the NCI. Melissa Garrido is supported by a Veterans Affairs Health Services Research and Development Career Development Award (Award No. CDA 11-201/CDP 12- 255). Amy Kelley was supported by the National Institute on Aging (NIA; Grant No. 1K23AG040774-01A1). Thomas Smith is supported by a grant from the NCI to the Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins University (Grant No. P30 CA 006973). Sean Morrison received a Midcareer Investigator Award in Patient- Oriented Research from the National Institutes of Health (Award No. 5K24AG022345) during the course of this work. This work was supported by the NIA, the Claude D. Pepper Older Americans Independence Center at the Icahn School of Medicine at Mount Sinai (Grant No. 5P30AG028741), and the National Palliative Care Research Center. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. The authors thank Robert Arnold, Phil Santa Emma, Mary Beth Happ, Tim Smith, and David Weissman for their contributions to the Palliative Care for Cancer project. Funding Information: An early version of these results was presented at the Annual Assembly of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association, Philadelphia, Pennsylvania, February 26, 2015. The study was funded by the National Cancer Institute (NCI) and the National Institute of Nursing Research (Project No. 5R01CA116227-04). The study sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. All authors are independent of the study sponsors. Peter May is sponsored by a health economics fellowship from the Health Research Board of Ireland and by the NCI. Melissa Garrido is supported by a Veterans Affairs Health Services Research and Development Career Development Award (Award No. CDA 11-201/CDP 12- 255). Amy Kelley was supported by the National Institute on Aging (NIA; Grant No. 1K23AG040774-01A1). Thomas Smith is supported by a grant from the NCI to the Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins University (Grant No. P30 CA 006973). Sean Morrison received a Midcareer Investigator Award in Patient- Oriented Research from the National Institutes of Health (Award No. 5K24AG022345) during the course of this work. This work was supported by the NIA, the Claude D. Pepper Older Americans Independence Center at the Icahn School of Medicine at Mount Sinai (Grant No. 5P30AG028741), and the National Palliative Care Research Center. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. The authors thank Robert Arnold, Phil Santa Emma, Mary Beth Happ, Tim Smith, and David Weissman for their contributions to the Palliative Care for Cancer project. ",
year = "2016",
doi = "10.1377/hlthaff.2015.0752",
language = "English",
volume = "35",
pages = "44--53",
journal = "Health Affairs",
issn = "0278-2715",
publisher = "Project Hope",
number = "1",
}