The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.
Increased Satisfaction with Care and Lower Costs: Results of a Randomized Trial of In‐Home Palliative Care
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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“Outcomes were worse with first-line erlotinib, followed by an immediate switch to chemotherapy at progression.”
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 [102]
In the citing paper
“There was crossover in this study, so the authors could not analyze the association of mutation status with OS.”
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 [102]
In the citing paper
“In the trial by Gridelli et al,102 which was stopped early and is discussed under Recommendation B1, participants were unselected for EGFR mutation status; 13.8% of the participants in the intervention arm and 14.6% in the control arm had EGFR mutation–positive disease.”
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 [102]
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“It has been shown that a hospital-based palliative care service leads to positive patient satisfaction, fewer hospital admissions and in-hospital deaths, less invasive EOL treatments, or fewer hospital expenditures, all of which in turn promote quality of life (13-19).”
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“…ill patients revealed that patients receiving in-home palliative care reported greater improvement in satisfaction with care and were less likely to visit the emergency department or be admitted to the hospital than those receiving usual care, resulting in significantly lower costs of care [7].”
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“Studies of palliative care have found a significant reduction in symptom distress [5-7], lower rates of emergency department visits [8, 9], fewer and shorter hospital and intensive care unit admissions [8, 10], better mood and less depression [11, 12], enhanced quality of life [5, 11, 12], and a longer median duration…”
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Maier, B. O., Simon, S. T., Bausewein, C., Pralong, A., & Voltz, R. (2016) · MMW - Fortschritte der Medizin · doi:10.1007/s15006-016-7700-8 · Cited by 2
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“8 While most of the patients prefer home-based services, the outcome is not achieved in many of the cases.”
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“71,75 While most studies include patients with and without neurological disease, there is limited data showing the economic bene fi ts of home-based palliative care speci fi cally for patients with neurological disease.”
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“Our analysis indicates an improvement in comfort, symptom relief, and the possibility for patients to return home, which may be associated with an improvement in QoL [20, 21].”
Supportive Care for Superutilizers of a Managed Care Organization
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“, who found that within the Kaiser Permanente system, in-home palliative care significantly increased caregiver satisfaction while reducing costs of medical care at the end of life.(3) Caregivers expressed greater satisfaction with nurses than with doctors (primary care physicians and specialists).”
BackgroundHospital Executives’ Perceptions of End-of-Life Care
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Getting comfortable with death. Palliative care begins at home.
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“또한 가정호스피스는 생애말기의 증상을 호전시켜 삶의 질을 향상시키고 (11,12), 환자와 가족의 사별 과정에 영향을 주어 사별 후 남은 가족의 정신건강에도 긍정적인 영향을 미치며 (11), 응급실 방문이나 연명처치 등 부적절한 의료이용 을 줄여 의료비 절감 효과가 높은 것으로 평가되고 있 다(13,14).”
Integrated Palliative and End-of-Life Care
Molina, E. H., Álvarez-Rosete, A., Flores, S. L., & Pastrana, T. (2017) · Springer eBooks · doi:10.1007/978-3-319-56103-5_24 · Cited by 2
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Integrated Palliative and End-of-Life Care
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“9,45–49 However, it is important to point out that our results may underestimate the receipt of palliative care as they do not include care provided by nonphysician providers.”
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“[15] Similarly, many centres identified in this present study also provide hospice care free of cost.”
An 8‐year observational study of the death places of patients with COPD in Turkey
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“6,7 Although COPD causes more deaths and DALYs than most malignant diseases, our information about ELC and the place of death is mainly derived from studies on patients with malignancies.”
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“The patients enrolled in in-home PC were more likely to die at home ( p 0.001), less likely to visit the ER ( p = 0.01), and less likely to be admitted ( p 0.001), with lower inpatient hospital costs within the last 30 days of life [22].”
InfluentialGhati, N., Bhatnagar, S., Mahendran, M., Thakur, A., Prasad, K., Kumar, D., Dwivedi, T., Kalaivani, M., Tiwari, P., Gupta, R., et al. (2024) · Clinical Cancer Investigation Journal · doi:10.51847/j28oejwdvb · Cited by 2
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“Before the study, 13% of patients with advanced lung cancer were referred to hospice; afterward, 80% of such patients enrolled in hospices and the average length of stay in hospice increased from 10 days to 44 days [25].”
Bidart, A., & Paternostre, B. (2020) · Médecine Palliative · doi:10.1016/j.medpal.2019.08.016 · Cited by 2
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“Notably, multiple studies have found an association between late referral to PC programs and negative outcomes, including aggressive treatment within the few weeks prior to death, deterioration in patients’ QOL and comfort, and increased medical costs [4, 7–15].”
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“Sie senken die Anzahl der Hospitalisierungen [3] und die anfallenden Gesundheitskosten [14].”
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Scott, M., Imsirovic, H., Pugliese, M., Isenberg, S. R., Ramsay, T., Hsu, A. T., Ponka, D., Siu, H. Y., Manuel, D. G., & Tanuseputro, P. (2022) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2022.10.010 · Cited by 1
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NON-SMALL-CELL LUNG CANCER: Real-World Population-Based Cohorts’ Study
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“Receiving care in the comfort of one’s home can have significant psychological and emotional benefits for patients and their families [30], and the appropriate use of specialized devices can contribute significantly to achieving these goals.”
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Palliativmedizin: Ein Modell für Comparative Effectiveness Research?
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“In-home palliative care can improve patient satisfaction, increase likelihood of dying at home, and reduce emergency department visits and hospital admissions.(4) However, although hospital-based palliative consultation services have increased recently,(5) few hospitals in California operate outpatient palliative care…”
Location of Death and End-of-Life Care
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“It was evident that in-home palliative care significantly reduced the costs of medical care at the end of life and increased satisfaction of care (32).”
BackgroundReducing preventable hospitalizations: a study of two models of transitional care
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Nursing Advocacy for Optimal Palliative Care of Patients with Advanced Cancer
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“17 In this case, home-based care allowed the family to remain immersed within the social fabric of the village.”
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Dying in the Twenty-First Century
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Quality Measures for Oncologic Emergency Medicine
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CCM (Chronic Care Model) w ramach podstawowej opieki zdrowotnej
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Analysis of factors that determine hospitalization of emergency department patients
Szwamel, K., & Kurpas, D. (2016) · Family Medicine & Primary Care Review · doi:10.5114/fmpcr/63236 · Cited by 1
Providing Palliative Care for Patients With Lung Cancer
Bade, B. C., Silvestri, G. A., & Ford, D. W. (2017) · Clinical Pulmonary Medicine · doi:10.1097/cpm.0000000000000203 · Cited by 1
“In addition, the likelihood of dying at home was increased, while the likelihood of ER visit or hospital admission was decreased.(20) The following year, Gade and colleagues reported similar results through an inpatient interdisciplinary PC consultation.”
Baldwin, A., & Wilson, C. M. (2018) · Rehabilitation Oncology · doi:10.1097/01.reo.0000000000000090 · Cited by 1
“16 Brumley et al (2007) Randomized controlled trial, n = 298, comparing usual care with in-home PC Pts receiving in-home PC (including physical therapy) experienced greater improvement in satisfaction with care as well as less likely to visit emergency department/be admitted to hospital vs usual…”
MethodAllgemeine Aspekte der Palliativmedizin
Alt‐Epping, B., & Nauck, F. (2017) · Der Gynäkologe · doi:10.1007/s00129-017-4146-8 · Cited by 1
“Dabei war frühzeitig meist definiert als der Zeitpunkt derDiagnose einer inkurablen (Krebs-)Erkrankung ([2, 5, 10, 13, 19, 20, 22, 24, 25, 29]; vgl.”
BackgroundWhat Are the Arguments That Show Outpatient Palliative Care Is Beneficial to Medical Systems?
Rabow, M. W. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-3796-7.00071-9 · Cited by 1
de Oliveira, H. A., de Freitas, I. M., Braga, P. G., Santos, P. O. O., Alcântara, C. O., Cintra, M. T. G., & Bicalho, M. A. C. (2018) · Revista Médica de Minas Gerais · doi:10.5935/2238-3182.20180127 · Cited by 1
Cordasco, K. M., Moreau, J. L., & Chawla, N. (2019) · Seminars in Reproductive Medicine · doi:10.1055/s-0039-1692398 · Cited by 1
The economic challenges of palliative medicine
Smith, T. J., & Cassel, J. B. (2015) · doi:10.1093/med/9780199656097.003.0010 · Cited by 1
Lucey, M. R., O’Reilly, M., Coffey, S., Sheridan, J. F., Moran, S., Twomey, F., Conroy, M., Eager, K., & Currow, D. C. (2022) · International Journal of Palliative Nursing · doi:10.12968/ijpn.2022.28.6.254 · Cited by 2
Zafari, A., Mehdizadeh, P., Bahadori, M., Dopeykar, N., Teymourzadeh, E., & Ravangard, R. (2023) · Value in Health Regional Issues · doi:10.1016/j.vhri.2023.11.006 · Cited by 1
Meines, N. V., & Enguidanos, S. M. (2024) · doi:10.1093/med/9780197542958.003.0015 · Cited by 1
Self-citationEnd-of-Life Costs in Cancer Patients: A Systematic Review
Süffert, S. C. I., Mantese, C. E. A., Meira, F. R. D. C., Trindade, K. F. R. D. O., Etges, A. P. B. D. S., Alves, R. J. V., & Bica, C. G. (2024) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091241285890 · Cited by 1
Melo, V. D., Vanegas, G., O’Riordan, D. L., Kuruvilla, P., Pantilat, S. Z., Rabow, M. W., Chen, L.-M., & Bischoff, K. E. (2025) · Gynecologic Oncology · doi:10.1016/j.ygyno.2025.05.019 · Cited by 1
Increasing Comfort With End-of-Life Discussions
Berton, T. C. (2020) · Digital Scholarship - UNLV (University of Nevada Reno) · doi:10.34917/7645849 · Cited by 1
Palliative care consults in oncology: what are we waiting for? A case report
Kelliher, E. (2013) · SAGE Open Medical Case Reports · doi:10.1177/2050313x13500953 · Cited by 1
Palliative Care, Hospice Care, Advance Care Planning, and Advance Directives
Taylor, A. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-803523-8.00004-6 · Cited by 1
Satchidanand, N., Servoss, T. J., Singh, R. K. P. G., Bosinski, A. M., Tirpak, P., Horton, L. L., & Naughton, B. J. (2018) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/1049909118764093 · Cited by 1
“Previous evidence strongly suggests that consistent and early provision of palliative care for older patients can improve patient outcomes,(2,3) patient perceptions of care quality,(4-6) as well as cost of care.(7,8) Pneumonia is a common cause of hospitalization, reason for admission to the medical intensive care uni…”
BackgroundHammond, C., & Baxter, S. (2019) · Springer eBooks · doi:10.1007/978-3-030-19535-9_5 · Cited by 1
Enguidanos, S. M., Rahman, A., & Lomeli, S. (2022) · Journal of Palliative Medicine · doi:10.1089/jpm.2022.0065 · Cited by 1
“1 Brumley et al. (2007) showed that HBPC delivered by a managed care organization (MCO) significantly reduced Emergency Department (ED) visits, hospitalizations, and hospital days, while increasing patient satisfaction with care and rates of home death, 1 the place of death preferred by most…”
Self-citationEarly integration of palliative care in malignant hematology
Ruiz-Andia, M., & Vicens, J. (2023) · Annals of Palliative Medicine · doi:10.21037/apm-23-244 · Cited by 1
The Current Status of Palliative Care and Radiotherapy
Smith, T. J., & Ellsworth, S. G. (2013) · doi:10.1002/9781118607152.ch8 · Cited by 1
A Satisfying, Inexpensive but Briefer Hospital Survival with Palliative Care
Billings, J. A., & Blinderman, C. D. (2008) · Journal of Palliative Medicine · doi:10.1089/jpm.2008.0123 · Cited by 1
Effectiveness of Specialized Palliative Care for Patients with Advanced Cancer
Zimmermann, C. (2010) · TSpace (University of Toronto) · Cited by 1
Klinger, C. A. (2013) · TSpace (University of Toronto) · Cited by 1
Health Care Service Provision Over the Palliative Care Trajectory
Masucci, L. (2011) · TSpace (University of Toronto) · Cited by 1
Metadata
- 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
- 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
- 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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