JCO Study Underscores Importance of Early Palliative Care in Cancer

A study funded by the National Cancer Institute and National Institute for Nursing Research, published in the Journal of Clinical Oncology, highights yet again the economic advantage of early palliation in cancer.

Introducing palliative and supportive care options to the patient should not wait till the late stage of disease—a common misconception, not only among patients but also among providers. While providing cancer patients and their caregivers an improved quality of life, palliative care has been shown to be lower the cost of care when introduced early in treatment. The present study found similar results. Conducted across 5 hospitals in 5 different states in the United States, the study enrolled 969 advanced cancer patients between 2007 and 2011 to receive either palliative care along with standard oncologic care (256 patients), or standard care alone (713 patients). The authors describe the participating hospitals as high-volume tertiary-care medical and cancer centers with established palliative care consultation teams (PCCTs) using existing practice guidelines for pain and symptom management and communication.

The primary question that the researchers seeked to answer: "Does time to consult after admission impact PCCT effect on cost of hospital care?

The intervention was a consultation with an interdisciplinary team that included a specialist in pain management. The team provided guidance on treatment options, establishing goals of care and advance plans, and helping patients and family members select treatments that match their goals. Consultation was initiated at the request of the attending physician.

The primary outcome measure, the study describes, was total direct cost of hospital care, which was acquired from hospital accounting databases to reflect the actual cost of providing medication, test, procedure, or service to each patient.

The results:

• Palliative care consultation within 6 days of hospitalization reduced hospital costs by $1312 over patients receiving traditional care.
• Palliative care consultation within 2 days of hospitalization reduced hospital costs by an additional $968 over patients receiving traditional care for a total of $2208.

These reductions lowered the cost of hospital stays by 14% and 24%, respectively. These results present the potential for a huge cost saving with very early palliative care consultation. Based on these significant results, the authors conclude that the strategy of introducing early palliative care for cancer patients should be widely implemented.

Read an article on where palliative care stands in accountable care organizations, authored by 2 of the JCO study researchers: http://bit.ly/1BWWYgI