Foreman Thomas, Kekewich Mike, Landry Joshua, Curran Dorothyann
J Palliat Care. 2015;31(2):69-75. doi: 10.1177/082585971503100202.
A wealth of literature and economic analyses has shown that palliative care is associated with significant cost reductions compared to nonpalliative care. However, no one has assessed the impact of an inpatient palliative care consultation service on costs at the very end of life (48 to 72 hours before death). This retrospective cohort review of 100 inpatients at a large hospital in Ontario examines the effect of palliative care consultations on seven independent cost categories during this period: medical-imaging costs, physician costs, laboratory costs, pharmaceutical costs, other health professional costs, food services costs, and unit costs. Our study shows that patients who receive palliative care consultations are associated with significantly lower costs in the final 48 to 72 hours of life than their nonpalliative counterparts. Another significant finding was that the degree of cost reduction at the very end of life appears to be relative to how soon after the patient's admission the palliative care consultation was initiated.
大量的文献和经济分析表明，与非姑息治疗相比，姑息治疗能显著降低成本。然而，没有人评估过住院姑息治疗咨询服务对临终前（死亡前48至72小时）成本的影响。这项对安大略省一家大型医院100名住院患者的回顾性队列研究，考察了姑息治疗咨询在此期间对七个独立成本类别的影响：医学影像成本、医生成本、实验室成本、药品成本、其他医疗专业人员成本、食品服务成本和病房成本。我们的研究表明，接受姑息治疗咨询的患者在生命的最后48至72小时的成本明显低于未接受姑息治疗的患者。另一个重要发现是，临终时成本降低的程度似乎与患者入院后多久开始进行姑息治疗咨询有关。
