TY - JOUR
T1 - Outcomes of the Acute Palliative Care Unit in an Academic Medical Center
AU - Eti, Serife
AU - O'Mahony, Sean
AU - McHugh, Marlene
AU - Guilbe, Rose
AU - Blank, Arthur
AU - Selwyn, Peter
PY - 2014/6
Y1 - 2014/6
N2 - Background: The acute palliative care units (APCU) where the palliative medicine specialists are primarily in charge with medical management are being established in few academic medical centers. The purpose of this study is to review the demographics and outcomes of the APCU admissions and the economical implications to the Montefiore Medical Center, Bronx, New York.Methods:We retrospectively examined the demographics, diagnosis related groups (DRGs), length of hospital stay (LOS), discharge status and hospital charge data using data from intcernal cost accounting databases for consecutive admissions to the palliative care unit between February 2007and February 2010.Results:A total of 1837 patients were admitted. Six hundred eighty patients transferred from other medical-surgical units. Twenty two percent of the patients were admitted under other specialties but co-managed with the palliative medicine specialists. The top three DRGs were sepsis without or with mechanical ventilation and heart failure with major co-morbidities. The average length of stay was comparable to other medical surgical units. Seventy-two percent of the patients were discharged alive, 27% died in the hospital. The median charges were lower in the palliative care unit than in medical-surgical units (p<.0001). These benefits were more likely to occur if patients were managed directly by the specialists. Conclusion: Our data suggests that the APCU may provide cost effective, acute care for the patients with advanced chronic illness as well as the imminently dying in need of intensive symptom management.
AB - Background: The acute palliative care units (APCU) where the palliative medicine specialists are primarily in charge with medical management are being established in few academic medical centers. The purpose of this study is to review the demographics and outcomes of the APCU admissions and the economical implications to the Montefiore Medical Center, Bronx, New York.Methods:We retrospectively examined the demographics, diagnosis related groups (DRGs), length of hospital stay (LOS), discharge status and hospital charge data using data from intcernal cost accounting databases for consecutive admissions to the palliative care unit between February 2007and February 2010.Results:A total of 1837 patients were admitted. Six hundred eighty patients transferred from other medical-surgical units. Twenty two percent of the patients were admitted under other specialties but co-managed with the palliative medicine specialists. The top three DRGs were sepsis without or with mechanical ventilation and heart failure with major co-morbidities. The average length of stay was comparable to other medical surgical units. Seventy-two percent of the patients were discharged alive, 27% died in the hospital. The median charges were lower in the palliative care unit than in medical-surgical units (p<.0001). These benefits were more likely to occur if patients were managed directly by the specialists. Conclusion: Our data suggests that the APCU may provide cost effective, acute care for the patients with advanced chronic illness as well as the imminently dying in need of intensive symptom management.
KW - DRGs(diagnosis-related groups)
KW - acute palliative care unit
KW - economical implications
KW - length of stay
KW - outcome evaluation
KW - palliative care
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U2 - 10.1177/1049909113489164
DO - 10.1177/1049909113489164
M3 - Article
C2 - 23666616
AN - SCOPUS:84899951114
SN - 1049-9091
VL - 31
SP - 380
EP - 384
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
IS - 4
ER -