Effects of a Population Health Community-Based Palliative Care Program on Cost and Utilization
| Autor: | Andrew Mackenzie, Tamim Ahmed, Terri L. Maxwell, Ian Duncan, Maria Gatto, Robert Crook, Lori Yosick |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Palliative care Medicare Advantage Pharmacy Population health law.invention 03 medical and health sciences 0302 clinical medicine 030502 gerontology law Cost Savings Intervention (counseling) cost Medicine Humans community-based Community Health Services General Nursing Aged Ohio Retrospective Studies Aged 80 and over Social work business.industry Palliative Care Correction General Medicine Emergency department Health Care Costs Original Articles Patient Acceptance of Health Care Intensive care unit Home Care Services Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Family medicine Female 0305 other medical science business population health |
| Zdroj: | Journal of Palliative Medicine J Palliat Med |
| ISSN: | 1557-7740 1096-6218 |
| Popis: | Background: New population health community-based models of palliative care can result in more compassionate, affordable, and sustainable high-quality care. Objectives: We evaluated utilization and cost outcomes of a standardized, population health community-based palliative care program provided by nurses and social workers. Design: We conducted a retrospective propensity-adjusted study to quantify cost savings and resource utilization associated with a community-based palliative care program. We analyzed claims data from a Medicare Advantage (MA) plan and used a proprietary predictive model to identify 804 members at high risk for overmedicalized end-of-life care. We enrolled 204 members in the palliative care program and compared them with 600 who received standard, telephonic, health plan case management. We excluded members with fewer than two months of enrolled experience or those with insufficient data for analysis, leaving 176 members in the study group and 570 in the control group for evaluation. We compared differences in utilization and costs (medical and pharmacy), hospital admissions, bed days (acute and intensive care unit [ICU]), and emergency department visits. Setting/Subjects: A 30,000-member MA plan and a health system in Central Ohio between October 2015 and June 2016. Results: Members who received community-based palliative care showed a statistically significant 20% reduction in total medical costs ($619 per enrolled member per month), 38% reduction in ICU admissions, 33% reduction in hospital admissions, and 12% reduction in hospital days. Conclusion: A structured nurse and social work model of community-based palliative care using a predictive model to identify MA candidates for intervention can reduce utilization and medical costs. |
| Databáze: | OpenAIRE |
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