Hospital-ity ~ Palliative Care: Impact on Quality of

Care & Cost

Hospitality• A Relationship • The Act & Practice of Being

Hospitable• Hospitality derives from the Latin hospes–The meaning of "host" can be literally read as "lord of strangers

Hospital• "shelter" • "guest-house" • "friendliness to

guests"

Host• He who Receives

Guests," • Clinical 1780:

"pertaining to hospital patients or hospital care," from clinic + -al (2). Meaning "coldly dispassionate" (like a medical report) is recorded from 1928.

Improved Quality

Determine Quality by the Manner of the

People

Case Management Principles

• The Patient is the Focal Point.• Provide Information and Personal

Assistance• Support Informed Choices–More satisfying and less costly.

• Support the patient/physician Relationship• Respect and protect the Patients Right to

Choose• Enable Maximum Effect of Insurance

Benefits

Reduced Costs

Palliative Care Reduces Length of Stay

• Clarifies goals of care with patients and families.• Helps families to select medical treatments that meet

goals.• Assists families in decisions to withhold or withdraw death

prolonging treatments that do not meet goals.

• Mount Sinai Hospital Data -2001– Medicare Data: Palliative Care Patients spent 360 fewer

days in Mt. Sinai as compared to DRG-Matched patients not followed by Palliative care• Medicare patients who passed with LOS >14 days

Reductions in Total Costs for Medicare Beneficiaries in 2001

• Cost savings from palliative care = $757,555 per year for patients with LOS>14days

• Cost savings for Palliative Care = $455,936 per year for patients with LOS >28 days– Cost per day=total per DRG/Avg LOS per DRG for patients

who passed– Costs reduced by palliative care= Cost per day x number

of days saved by Palliative Care

IMPLICATIONS OF LOS REDUCTION

Patients with advanced illness have a long length of stay & high cost/admission.

Palliative Care results in:

Reduction in Length of StayReduction in Total Costs/AdmissionOpportunity for New AdmissionsBetter Quality of CareHighly Satisfied Families

Evaluate yourself by Your Own Standards, not

someone else’s.