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Healthcare Professionals Blog

Less is More

Less is more – and sometimes more is less.
With our healthcare system in crisis mode, it seems like sheer fantasy that we could deliver more care and actually spend less money.  But according to an article in the March 2011 issue of Health Affairs, the use of high-quality palliative care in seriously ill patients might actually make that fantasy a reality.
The study looked at Medicaid-insured patients in four hospitals in New York state (New York City, Rochester, and Buffalo) who had a range of life-limiting illnesses.  It compared patients who had received palliative care during their hospitalization to patients who had the same condition but had only received “standard care.” 


The result: patients who received palliative care incurred an average of $6,900 less cost for the admission than those who did not.  The cost savings for patients who were discharged from the hospital alive was $4,098 on average, and for patients who died in the hospital it was $7,563.  Length of stay did not change significantly, but patients receiving palliative care spent significantly less time in ICUs and had a lower cost per hospital day.  The percentage of deaths occurring in the ICU was much lower in the palliative care group (34% vs. 58%) and nearly 30% of the patients discharged alive from the palliative care group received hospice care in some appropriate setting, as opposed to near 0% in the non-palliative care group.
It would seem that what patients need most from our healthcare system is not cure, but relief.  Cure alone leaves people with untreated pain, unremitting suffering, and unanswered existential questions.  Palliative care, especially high quality care like what was provided in the hospitals under discussion, takes care of these issues alongside curative treatment.  It offers relief.   It offers the patient a chance to feel whole again.
Apparently, that feeling of wholeness is equal to several thousand dollars worth of treatment.  If the moral imperative to provide this kind of compassionate, dignified care to suffering patients isn’t enough, surely this level of financial incentive should be enough to get all hospitals on a path to integrating palliative care into their approach to illness. 
What do you think? Join the discussion by posting a comment below.

Written by on March 28th, 2011 at
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