Effects of Community Based Palliative Care on Health Care Utilization in Patients with Advanced Heart Failure
Topic: Specific Patient Populations
In 2000, patients with advanced heart failure accounted for the second highest number of hospital days in Canada. We propose that providing home-based palliative care (PC) for these patients can meaningfully reduce the number of hospital visits and days in hospital, with the ultimate goal of improving patient’s overall satisfaction with care and quality of life.
In a Quality Improvement (QI) analysis of health care utilization of a sample of patients with advanced heart failure (HF) in a tertiary hospital in an urban setting, we measured and compared the rate of clinic visits, emergency department (ED) visits, hospital admissions, and days in hospital before and after implementing home-based palliative care.
A total of 32 patients with HF (69% female, M=83.6 years of age) were seen in the home-based PC program over a 2 year period. In a pre- and post-intervention comparison, meaningful reductions were seen in rates of clinic visits, ED visits, hospital admissions, and days in hospital.
Home-based care of patients with HF can lead to decreased health care utilization. In turn, we hope it can reduce both patient and system burden and result in greater health-related quality of life for patients with advanced heart failure.
- Leah Steinberg, MD
- Temmy Latner Centre for Palliative Care, Mount Sinai Hospital
- 60 Murray St, 4th floor, Box 13
- Dr. Amna Husain
- Dr. Jennifer Arvanitis
- Dr. Russell Goldman
- Dr. Susanna Mak
- Meghan White