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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]
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“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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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
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