Center to Advance Palliative Care

For Patients and Families
Partner
Sponsor
 
  Print this page
Views

CAPC Palliative Care Discussion Forum
Data Collection and Measurement

Next Reply: Re:How do we know Palliative Care saves money?
Previous Message: Assessments and data collection process
Next Message: Survey Returns

Post How do we know Palliative Care saves money?
Author: Christine
Date: Jun 25, 2008 8:57 am
Our consult program has been around 10 years and has been supported because it is the "right thing to do" but has never been asked to justify the costs of the program, until now.

What is the best method for comparing people with a pc consult to those with none to demonstrate past cost avoidance. I know the resources on this site are great, but seem to focus on potential patients and I need to compare past data. Do we do a DRG to DRG comparison? Do we limit it to only those that died in the hospital, even if one of our goals is helping patients who want to die at home do so? One of the tools on this site ask for the averge LOS days saved - but I didn't see how to calulate this.
I'm new to this position so any help would be greatly appreciated!!!
Replies: order by [Date] [Author] [Subject]
Re:How do we know Palliative Care saves money? (by sutton on 06/26/2008)
We, too, were funded for about 10 years because it was the "right thing to do". We are just putting together now a report to justify an increase in our staffing. We have had some wonderful help from administration in putting this together.

These are some of the references we used
Morrison et al American Geriatrics Society Annual Meeting Abstracts 2007.

Back et al Journal of Palliative Care 2005: 8:25-35

Penrod et al. Journal of Palliative Medicine 2006: 9(4): 855-860

The CAPC audio conference program, "Using Your Own Data: Updating Your Business Plan to Ensure Sustainability--January 24, 2008-- was also very helpful.
Re:How do we know Palliative Care saves money? (by jbcassel on 11/03/2008)
Hi. You may have solved all your problems in the past couple of months but if not here are some thoughts. First, regarding impect on total LOS: published literature indicates no effect of PC consults on total LOS, and this is terribly difficult to try to assess using retrospective analyses. However several studies do demonstrate impact on ICU days and you can simply assess how many of your consults were in the ICUs, how many pts transferred out of ICU to acute beds, and how many days did they then stay in those acute beds before death or discharge and use that as a sum of ICU impact days. Second, regarding actual methods for demonstrating cost avoidance, we recommend two steps (and not any DRG-to-DRG comparisons). 1) Take those patients you consulted, determine average direct cost per day in 5+ days prior to consult and 5+ days following consult, compute average direct cost per day difference, multiply by # of cases. 2) Take all adult non-trauma deaths in your hospital, limit to those with 5+ or 10+ days in hospital, segregate into those with PC consults some days prior to death and those without PC, compare direct costs of those last 5-10 days. Third, refer to the recent Morrison et al. study published in Archives of Internal Medicine. While you probably don't want to replicate something as complicated as propensity score matching, you can at least refer to the results of that study to buttress your own findings. I can also send you the slides and handouts that Kathleen Kerr and I used at CAPC Level II seminar in Orlando last year, if they're not available on the CAPC website anymore. Let me know if this helps. Brian Cassel, VCU PCLC, jbcassel@vcu.edu, 804-628-1926.

IMPORTANT: In order to post a new message or reply to an existing post in the discussion you must login. If you are not a registered member you may join here.
The statements posted in the forum section of capc.org are opinions expressed by website visitors and do not necessarily represent the viewpoints or positions of the Center to Advance Palliative Care(CAPC). CAPC is not responsible for the factual or legal accuracy of any of the statements posted.


General questions about using the CAPCconnect™ palliative care discussion forum?
Email: Jennifer.Raiten@mssm.edu

Lost login username/password questions? Email: Margaret.Schutz@mssm.edu