Late Life Care Approach Decreased Utilization and TCOC

Topic: Measuring Impact and Value

 

Alinea Health 1 Late Life Care Approach.jpg

Aim: Evaluate the effects of LifeCourse, a late life care approach, on healthcare utilization and total cost of care in a large healthcare delivery system.

Data: 373 intervention and 201 usual care patients between October 2012 and April 2015. A subset of patients with total cost of care claims data available was selected for cost analysis, with controls selected from the healthcare system’s patient population and matched using propensity scores.

Results:  LifeCourse patients in their last 6 months of life had half as many inpatient days as usual care controls.  No significant difference in the number of ED visits. The proportion of advance directives increased significantly in the follow-up period compared to usual care. LifeCourse patients experienced higher inpatient and community-based palliative care utilization. The proportion of hospice enrollment prior to death was higher in the intervention group than the usual care group, the healthcare system in general, and the 2013 NHPCO national estimate. Also, average per patient per month total expenditures decreased more in the intervention group.

Conclusions: Early signals indicate that using a whole person approach and allowing patients to voice preferences and take part in care decisions may benefit utilization and total cost of care.

Author

  • Laura Sutter, MPH
  • Research Coordinator
  • Allina Health
  • 2925 Chicago Ave., MR 10039
  • Minneapolis, MN 55407
  • (612) 262-0534

Co-authors

  • Heather Britt, MPH, PhD
  • Karl Fernstrom, MPH
  • Rebecca Prenevost, MPH, PhD
  • TC Tong

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