Early Decisions about Palliative Care = Significant Reductions in Hospital Costs
Written by: Lynne E. Porter M.D., FACP
If PCPs are proactive in bioethics training and know to request a bioethics consult when it is time to introduce patients and their families to palliative care, they can be compassionate and caring while significantly reducing hospital costs. This strategy achieves savings in at least two ways:
- Avoids initial admission to the ICU, one of the highest cost areas for hospitals. One day of usage badly impacts re-imbursement. Medicare pays only 83% of costs with an ICU stay vs. 105% of costs without one!
- Reduces re-admission to the ICU. In a study done with 100 ICU patients, inpatient re-admission rates decreased from 73% to 33%, when a bioethics consult was utilized.
It can be understandably difficult for PCPs to discuss palliative care issues with a longtime patient who is failing. But with the help of a bioethicist, these difficult decisions can be worked through with honesty, kindness, and sensitivity. Patients and their families will be much more comfortable using non-ICU beds for care when all of their concerns have been answered. Even in today’s complex healthcare arena, a PCP with good bioethics backup can deliver caring, patient-centered treatment and peace of mind for families, while practicing cost-effective medicine simultaneously!