Smith Thomas J, Cassel J Brian
Department of Medicine, Virginia Commonwealth University, Massey Cancer Center, Richmond, Virginia, USA.
J Pain Symptom Manage. 2009 Jul;38(1):32-44. doi: 10.1016/j.jpainsymman.2009.05.001.
Although palliative care is rarely profitable by itself, palliative care in hospitals is associated with significant reductions in per diem costs and total costs, and can generate substantial savings to the health system by "cost avoidance." Palliative care alongside usual care in recent randomized outpatient trials has maintained or improved the quality of care while generating substantial cost savings. The data are mixed about the impact of palliative care consultation on inpatient length of stay and are related to local patterns of care, consultation, and assumption of control of the course of care. In collecting and presenting the data to administrators and others, we have found that the simplest approach is the most effective-for example, presenting a few clinical outcomes alongside cost-saving data.
尽管姑息治疗本身很少能盈利,但医院中的姑息治疗与每日费用和总成本的显著降低相关,并且可以通过“避免成本”为卫生系统节省大量资金。在最近的随机门诊试验中,姑息治疗与常规护理相结合,在节省大量成本的同时,维持或提高了护理质量。关于姑息治疗咨询对住院时间的影响,数据并不一致,这与当地的护理模式、咨询以及对护理过程的控制假设有关。在向管理人员和其他人收集和呈现数据时,我们发现最简单的方法是最有效的——例如,在呈现成本节约数据的同时展示一些临床结果。