Early palliative care consults reduce patients' length of stay and overall hospital costs


Advocate Aurora Health, Research Institute


Palliative care improves health outcomes and satisfaction and supports decision-making for patients and families during challenging times in their lives. Earlier referral for consults has demonstrated increased costs savings. Education proposing physicians order a palliative care consult within 3 days of patient hospital admission will decrease patient length of stay (LOS) and overall costs as well as expedite the transition to next level of care. A descriptive retrospective cohort study was completed using de-identified data originally captured for a system-wide initiative at a large acute care hospital in Illinois. Hospitalists were selected as the pilot group and received education encouraging physicians to order palliative care consults within 3 days of patient admission. Non-hospitalists (control group) did not receive the education. All results were compared to a 3-month baseline period. A total of 711 patients were included in this study (367 baseline, 138 pilot, 206 controls). The baseline pre-consult LOS of 4.8 days was reduced to 3.7 days in the pilot group, representing a > 1 day decrease in the timing of palliative consult. The pilot demonstrated a direct cost savings of 26% over the 3-months pilot period. Additionally, a 2-day reduction in overall LOS was demonstrated in the pilot group compared to both the baseline and control groups. This pilot demonstrated an ability to change the timing of new palliative care consults, resulting in direct cost savings and LOS reduction. These results demonstrated the need for a larger study to confirm these findings.

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