title: The business of palliative medicine--part 4: Potential impact of an acute-care palliative medicine inpatient unit in a tertiary care cancer center.
abstract: In this study, a hematology/oncology computerized discharge database was qualitatively and quantitatively reviewed using an empirical methodology. The goal was to identify potential patients for admission to a planned acute-care, palliative medicine inpatient unit. Patients were identified by the International Classifications of Disease (ICD-9) codes. A large heterogenous population, comprising up to 40 percent of annual discharges from the Hematology/Oncology service, was identified. If management decided to add an acute-care, palliative medicine unit to the hospital, these are the patients who would benefit. The study predicted a significant change in patient profile, acuity, complexity, and resource utilization in current palliative care services. This study technique predicted the actual clinical load of the acute-care unit when it opened and was very helpful in program development. Our model predicted that 695 patients would be admitted to the acute-care palliative medicine unit in the first year of operation; 655 patients were actually admitted during this time.
authors.affiliation: The Harry R. Horvitz Center for Palliative Medicine (A World Health Organization Demonstration Project), Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: Declan
authors.initials: D
authors.lastname: Walsh
mesh_terms: D000208:Acute Disease; D000368:Aged; D006738:Hospices / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D017146:Models, Organizational; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D009820:Ohio; D016522:Oncology Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D009936:Organizational Innovation; D010166:Palliative Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data*; D010347:Patient Care Planning / Q000458:organization & administration; D010351:Patient Discharge / Q000706:statistics & numerical data