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Impact of an Inpatient Palliative Care Team: A Randomized Controlled Trial
Abstract
BACKGROUND: Palliative care improves care and reduces costs for hospitalized patients with life-limiting illnesses. There have been no multicenter randomized trials examining impact on patient satisfaction, clinical outcomes, and subsequent health care costs. OBJECTIVE: Measure the impact of an interdisciplinary palliative care service (IPCS) on patient satisfaction, clinical outcomes, and cost of care for 6 months posthospital discharge. METHODS: Multicenter, randomized, controlled trial. IPCS provided consultative, interdisciplinary, palliative care to intervention patients. Controls received usual hospital care (UC). SETTING AND SAMPLE: Five hundred seventeen patients with life-limiting illnesses from a hospital in Denver, Portland, and San Francisco enrolled June 2002 to December 2003. MEASURES: Modified City of Hope Patient Questionnaire, total health care costs, hospice utilization, and survival. RESULTS: IPCS reported higher scores for the Care Experience scale (IPCS: 6.9 versus UC: 6.6, p = 0.04) and for the Doctors, Nurses/Other Care Providers Communication scale (IPCS: 8.3 versus UC: 7.5, p = 0.0004). IPCS patients had fewer intensive care admissions (ICU) on hospital readmission (12 versus 21, p = 0.04), and lower 6-month net cost savings of $4,855 per patient (p = 0.001). IPCS had longer median hospice stays (24 days versus 12 days, p = 0.04). There were no differences in survival or symptom control. CONCLUSIONS: IPCS patients reported greater satisfaction with their care experience and providers' communication, had fewer ICU admissions on readmission, and lower total health care costs following hospital discharge.
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“Median OS was 9.2 versus 6 months, favoring nivolumab (HR, 0.59; 95% CI, 0.44 to 0.79; P < .001).”
From Systemic Therapy for Stage IV Non–Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update (2015) · cites this paper as [101]
In the citing paper
“On March 14, 2015, the FDA approved nivolumab for the treatment of patients with metastatic squamous cell NSCLC with disease progression who had received ≥ one prior platinum-based regimen”
From Systemic Therapy for Stage IV Non–Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update (2015) · cites this paper as [101]
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Five Policies to Promote Palliative Care for Patients with ESRD
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Use of inpatient palliative care services in patients with metastatic incurable head and neck cancer
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Palliative care: needs of advanced breast cancer patients
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ICU Bedside Nurses' Involvement in Palliative Care Communication: A Multicenter Survey
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Early integration of palliative care into oncology: evidence, challenges and barriers.
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Palliative Care Transitions From Acute Care to Community-Based Care—A Systematic Review
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Metadata
- Authors
- Gade, G., Venohr, I., Conner, D., McGrady, K., Beane, J., Richardson, R. H., Williams, M. P., Liberson, M., Blum, M., & Penna, R. D.
- Affiliations
- Department of Internal Medicine, Denver, Colorado.
- Kaiser Permanente (US)
- Colorado Permanente Medical Group (US)
- Oregon Health & Science University (US)
- Kaiser Foundation Hospital (US)
- Palliative Care Service, Permanente Medical Group, Sacramento, California.
- Care Management Institute, Kaiser Permanente, Oakland, California.
- Venue
- Journal of Palliative Medicine
- Publisher
- SAGE Publications
- Published
- 2008-03
- Volume
- 11
- Issue
- 2
- Pages
- 180-190
- ISSN
- 1096-6218 (ISSN-L)
- 1557-7740
- OpenAlex
- W1987578786
- Cited by
- 564
- References
- 53
- Citations by year
- 2026: 10 · 2025: 14 · 2024: 28 · 2023: 14 · 2022: 37 · 2021: 30 · 2020: 43 · 2019: 40 · 2018: 39 · 2017: 66 · 2016: 46 · 2015: 42 · 2014: 46 · 2013: 40 · 2012: 26
- FWCI
- 14.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Palliative Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- palliative care, inpatient palliative care, life-limiting illness, patient satisfaction, health care costs, hospital readmission, intensive care unit admission, hospice use, physician-patient communication, post-discharge outcomes
- MeSH terms
- Aged, Cooperative Behavior, Hospitalization, Humans, Palliative Care, Patient Care Team, Prospective Studies, Quality of Life, Survival Rate, Advance Directives, Critical Illness, Hospice Care, Patient Satisfaction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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