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Prospective cohort study of hospital palliative care teams for inpatients with advanced cancer: earlier consultation is associated with larger cost-saving effect
▸ May P, Garrido MM, Cassel JB, et al. J Clin Oncol 2015;33:2745–52.
This US based multicentre prospective observational hospital study in adults with advanced cancer assessed how the timing of palliative care consultation impacts on patient and family outcomes, processes of care and hospital utilisation. Nearly 6000 patients were admitted to the five hospitals in the USA with an advanced cancer diagnosis, 3218 patients were enrolled onto the study, of whom 1537 patients had adequate data for matching and analysis (374 were seen by a palliative care consultation team; 1163 received usual care only). In view of cost data acquisition and deaths, the final sample for economic evaluation was 969 patients (256 palliative care; 713 usual care). Earlier palliative care consultation was associated with a larger cost saving. Palliative care consultation within 6 days of admission was estimated to reduce costs by US$1312 compared with usual care and consultation within 2 days reduce costs by US$2280; a 14% and a 24% decrease in total direct hospital costs, respectively. Cost savings are due to reduced length of stay and reduced intensity of stay (laboratory and pharmacy costs). Length of stay was also reduced if the palliative care consultation occurred within 2 days of admission. These findings suggest that, in the USA, early palliative care is cost effective.
What bothers lung cancer patients the most? A prospective, longitudinal electronic patient-reported outcomes study in advanced non-small cell lung cancer
▸LeBlanc TW, Nickolich M, Rushing CN, et al. Support Care Cancer 2015. Published Online First.
In a longitudinal single-site symptom study in 2008, 97 patients with advanced non-small cell lung cancer completed an electronic symptom assessment tool at up to four clinic visits. They had a mean time from the initial lung cancer diagnosis of 534 days and a median survival from study enrolment of 354 days. Their main concerns were difficulty with doing hard activity, household work, running as well as fatigue, pain, dyspnoea and insomnia. Over …
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