Background Ultrasound is a diagnostic tool that can support clinical examination. Its use across the hospice and community palliative care setting can lead to significant cost savings with the avoidance of a hospital admission and/or the cost of hospital based interventional radiology service. Over the course of four years, 150 patients were clinically assessed with ultrasound by members of the hospice medical team (who had all received training in focussed abdominal ultrasound) and comprehensive details were recorded of their assessments.
To ascertain if a hospice–based paracentesis service helped to reduce hospital admissions and/or interventional radiology input;
That having a hospice–based paracentesis service helped patients to remain in their preferred place of care;
That our hospice–based paracentesis service significantly decreased the costs to our local acute NHS services.
Method Retrospective review of patient data collected from all ultrasound scans undertaken by the hospice medical team between 2015–2018.
Results Access to ultrasound at the point of care enabled over 95% of patients to be safely managed within the hospice setting.
Only 3% of patients required transfer to hospital over a four-year period therefore avoiding either hospital admission or interventional radiology need for paracentesis.
The service was extended to include outpatients and the community. This coincided with an increase in cases with non-malignant liver disease referred to the hospice.
Conclusion The study demonstrated that we are able to avoid hospital admission for the majority of our patients resulting in significant cost savings for our local NHS trust as well as keeping patients in their preferred place of care for symptom management. What are the next steps?