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Palliative Care in Long Term Care Settings

Next Reply: Re:Pall Care Avoidance of Readmissions in LTAC/SNF
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Post Pall Care Avoidance of Readmissions in LTAC/SNF
Author: ShawnCharest
Date: Jun 7, 2012 1:06 pm
Does anybody have any data about what percentage of palliative care patients in LTAC/SNF settings are able to avoid readmission to the hospital as opposed to a standard "control" population not receiving palliative care?
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Re:Pall Care Avoidance of Readmissions in LTAC/SNF (by lhanson on 06/14/2012)
There just isn't systematic testing of this intervention yet; you'll have to consider what has been done in LTC (internal programs and special ACP interventions) and then extrapolate. Volicer's early study of a dementia special care unit demonstrated some cost reductions based on a palliative care approach, but they didn't look at readmission specifically. Molloy's RCT of advance directive implementation showed significant reduction in hospitalization, as did Casarett's RCT offering hospice proactively in this population. You might also take a look at the small study by Cari Levy -- another proactive ACP program that found reduction in hospitalization at the time of death.
Hope this helps!
Re:Pall Care Avoidance of Readmissions in LTAC/SNF (by SharolHerr on 06/14/2012)
I'm not aware of any data about avoiding readmission form LTAC/SNF. In our interface with SNF's for skilled palliative care, we have found that a key to avoiding the rehospitalization is clarifying resuscitation status and goals of care at the outset of the skilled palliation. Having staff readily available and following the patient so they can help in transitioning the plan of care if the patient is no longer able to meet the skilled goals is also very important to avoid readmits.

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