Cited by 845Palliative Care and End-of-Life IssuesPalliative and Oncologic CarePain Management and Opioid Use

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Increased Satisfaction with Care and Lower Costs: Results of a Randomized Trial of In‐Home Palliative Care

Brumley, Richard, Enguidanos, Susan, Jamison, Paula, Seitz, Rae, Morgenstern, Nora, Saito, Sherry, McIlwane, Jan, Hillary, Kristine, Gonzalez, Jorge·2007·Journal of the American Geriatrics Society

DOI 10.1111/j.1532-5415.2007.01234.x

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Abstract

OBJECTIVES: To determine whether an in‐home palliative care intervention for terminally ill patients can improve patient satisfaction, reduce medical care costs, and increase the proportion of patients dying at home. DESIGN: A randomized, controlled trial. SETTING: Two health maintenance organizations in two states. PARTICIPANTS: Homebound, terminally ill patients (N=298) with a prognosis of approximately 1 year or less to live plus one or more hospital or emergency department visits in the previous 12 months. INTERVENTION: Usual versus in‐home palliative care plus usual care delivered by an interdisciplinary team providing pain and symptom relief, patient and family education and training, and an array of medical and social support services. MEASUREMENTS: Measured outcomes were satisfaction with care, use of medical services, site of death, and costs of care. RESULTS: Patients randomized to in‐home palliative care reported greater improvement in satisfaction with care at 30 and 90 days after enrollment ( P <.05) and were more likely to die at home than those receiving usual care ( P <.001). In addition, in‐home palliative care subjects were less likely to visit the emergency department ( P =.01) or be admitted to the hospital than those receiving usual care ( P <.001), resulting in significantly lower costs of care for intervention patients ( P =.03). CONCLUSION: In‐home palliative care significantly increased patient satisfaction while reducing use of medical services and costs of medical care at the end of life. This study, although modest in scope, presents strong evidence for reforming end‐of‐life care.

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“5 Despite this result, the study found a signiﬁcantly lower cost of care for HBPC patients.”
Home-based Palliative Intervention to Improve Quality of Life in Children with Cancer: A Randomized Controlled Trial
Andriastuti, M., Halim, P. G., Tunjungsari, E., & Widodo, D. P. (2022) · Asian Pacific Journal of Cancer Prevention · doi:10.31557/apjcp.2022.23.9.3029 · Cited by 16
“Several other studies have also reported similar results so that palliative intervention can provide a better QoL and also improve the end-of-life stage (Davis et al., 2015; Brumley et al., 2007; Gade et al., 2008; Pantilat et al., 2010).”
Result
Testing models of care for terminally ill people who live alone at home: is a randomised controlled trial the best approach?
Aoun, S. M., O’Connor, M., Breen, L. J., Deas, K., & Skett, K. (2012) · Health & Social Care in the Community · doi:10.1111/hsc.12002 · Cited by 16
“A randomised controlled trial (RCT) of home-based palliative care reported greater satisfaction with care, fewer hospital admissions, and an increased likelihood of dying at home for patients assigned to the home-based intervention compared with usual care, which comprised various levels of primary and acute care serv…”
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Patient satisfaction with health care services at a national institute of ophthalmology
Huy, N. V., Dung, N. N., Thang, C. D., & Hanh, L. T. (2017) · The International Journal of Health Planning and Management · doi:10.1002/hpm.2449 · Cited by 16
“Data was collected on (1) age, (2) sex, (3) ethnic group (King, others), (4) residence (urban area, rural area), (5) highest educational level (illiterate, primary school, secondary school, high school, voluntary school/college, university/post‐ graduate), (6) occupation (worker/officer/businessman, farmer/freelancer,…”
Background
Das Lebensende in der Schweiz - Individuelle und gesellschaftliche Perspektiven
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An evaluation of the cost‐effectiveness of the different palliative care models available to cancer patients in Turkey
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BackgroundInfluential
Methodological challenges and potential solutions for economic evaluations of palliative and end-of-life care: A systematic review
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“53,93 Mixed results on the costs and cost-effectiveness of palliative care have been published, showing that palliative care can result in lower, 113,114 equal 115,116 or higher 117 costs compared to usual care.”
Background
From Whole Brain to Hospice: Patterns of Care in Radiation Oncology
Stavas, M. J., Arneson, K. O., Friedman, J., & Misra, S. (2014) · Journal of Palliative Medicine · doi:10.1089/jpm.2013.0549 · Cited by 15
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“Conclusion : Les heures consacrées aux soins INTRODUCTION In health care systems around the world (1-7), including Canada’s (8, 9), home care is becoming an important context for providing palliative and end-of-life care.”
Influential
Palliative care and the Portuguese health system
da Cruz, M. B., & Nunes, R. (2016) · Porto Biomedical Journal · doi:10.1016/j.pbj.2015.07.002 · Cited by 15
Correlation of Palliative Performance Scale and Survival in Patients With Cancer Receiving Home-Based Palliative Care
Cai, J., Guerriere, D. N., Zhao, H., & Coyte, P. C. (2018) · Journal of Palliative Care · doi:10.1177/0825859718755249 · Cited by 15
Protocol for a Noninferiority Comparative Effectiveness Trial of Home-Based Palliative Care (HomePal)
Nguyen, H. Q., Mularski, R. A., Edwards, P. E., Lynn, J., Machado, M. T., McBurnie, M. A., McMullen, C. K., Mittman, B. S., Reinke, L. F., Shen, E., et al. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2019.0116 · Cited by 15
“The current standard HBPC 12,13 approach across our clinical sites is to utilize the RN case managers to initiate the evaluation and lead the team-based care.”
Palliative Care for People Living With Heart Disease—Does Sex Make a Difference?
Sobański, P., Krajnik, M., & Goodlin, S. J. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.629752 · Cited by 16
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Blum, T. G., & Schönfeld, N. (2014) · European Respiratory Journal · doi:10.1183/09031936.00072514 · Cited by 16
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Impact of Home Hospice Care on Patients with Advanced Lung Cancer: A Longitudinal Population-Based Study in Taiwan
Chiang, J., & Kao, Y.-H. (2015) · Journal of Palliative Medicine · doi:10.1089/jpm.2015.0278 · Cited by 15
Integration of a Palliative Care Intervention into Community Practice for Lung Cancer: A Study Protocol and Lessons Learned with Implementation
Nguyen, H. Q., Cuyegkeng, T., Phung, T. O., Jähn, K., Borneman, T. R., Macias, M. M., Ruel, N. H., & FERRELL, B. R. (2017) · Journal of Palliative Medicine · doi:10.1089/jpm.2017.0143 · Cited by 15
“…system with over 11 million members across the United States, was selected as the ideal, ‘‘real-world’’ test bed to extend this work, given its early leadership in the development, evaluation, and system-wide implementation of inpatient 6 and home-based PC services 7,8 since the mid 2000s.”
Protocol and pilot testing: The feasibility and acceptability of a nurse-led telephone-based palliative care intervention for patients newly diagnosed with lung cancer
Reinke, L. F., Vig, E. K., Tartaglione, E. V., Backhus, L. M., Gunnink, E. J., & Au, D. H. (2017) · Contemporary Clinical Trials · doi:10.1016/j.cct.2017.11.013 · Cited by 15
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Emerging Models of Providing Oncology Palliative Care
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Harman, L. E., Guthrie, D. M., Cohen, J., Declercq, A., Fisher, K., Goodridge, D. M., Hirdes, J. P., & Seow, H. Y. (2019) · BMC Palliative Care · doi:10.1186/s12904-018-0389-y · Cited by 15
Aetna's Compassionate Care Program: Sustained Value for Our Members with Advanced Illness
Baquet-Simpson, A. M., Spettell, C. M., Freeman, A. N., Bates, A. M., Paz, H. L., Mirsky, R., Knecht, D., & Brennan, T. A. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2018.0359 · Cited by 15
Organisation des soins palliatifs en Belgique
Keirse, E. A., Beguin, C., Desmedt, M. S., Deveugele, M. I., Menten, J. J., Simoens, S., Wens, J., Borgermans, L. A. D., Kohn, L., Spinnewijn, B., et al. (2009) · doi:10.57598/r115b · Cited by 15
A Comparison Between End-of-Life Home Care Clients With Cancer and Heart Failure in Ontario
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Availability of home palliative care services and dying at home in conditions needing palliative care: A population-based death certificate study
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Improving Hospital’s Quality of Service in Vietnam: The Patient Satisfaction Evaluation in Multiple Health Facilities
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Community Nurses’ Preparations for and Challenges in Providing Palliative Home Care: A Qualitative Study
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“The dementia/functionally impaired subgroup should be considered for home-based palliative care either alongside or as a transition from home-based primary care, to support effective management of prevalent physical and psychological symptoms, facilitate complex medical decision-making, and provide caregiver support.(…”
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Focusing Together on the Needs of the Sickest 5%, Who Drive Half of All Healthcare Spending
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Longitudinal Symptom Burden Trajectories in a Population-Based Cohort of Women with Metastatic Breast Cancer: A Group-Based Trajectory Modeling Analysis
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Authors: Brumley, R., Enguidanos, S., Jamison, P., Seitz, R., Morgenstern, N., Saito, S., McIlwane, J., Hillary, K., & Gonzalez, J.
Affiliations: Kaiser Permanente (US)
Partners in Care Foundation (US)
ORCID: Enguidanos, Susan
Venue: Journal of the American Geriatrics Society
Publisher: Wiley
Published: 2007-06-18
Volume: 55
Issue: 7
Pages: 993-1000
ISSN: 0002-8614 (ISSN-L)
1532-5415
DOI: 10.1111/j.1532-5415.2007.01234.x
OpenAlex: W2108517568
Cited by: 845
References: 28
Citations by year: 2026: 20 · 2025: 20 · 2024: 39 · 2023: 25 · 2022: 46 · 2021: 56 · 2020: 67 · 2019: 54 · 2018: 56 · 2017: 69 · 2016: 76 · 2015: 63 · 2014: 66 · 2013: 54 · 2012: 41
FWCI: 19.56
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of the American Geriatrics Society (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: end-of-life care, patient satisfaction, health care costs, home death, dying patients, homebound patients, emergency department visits, hospitalization, interdisciplinary care teams, symptom management, health maintenance organizations
MeSH terms: Aged, Female, Health Maintenance Organizations, Home Care Services, Humans, Male, Palliative Care, Patient Education as Topic, Prognosis, Retrospective Studies, Health Care Costs, Patient Satisfaction, Terminally Ill

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Increased Satisfaction with Care and Lower Costs: Results of a Randomized Trial of In‐Home Palliative Care

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