title: The financial benefits of acute inpatient palliative medicine: an inter-institutional comparative analysis by all patient refined-diagnosis related group and case mix index.
abstract: Financial comparisons of acute care hospital services are possible using the Centers for Medicare & Medicaid Services case mix index (CMI) and All Patient Refined-Diagnosis Related Group (APR-DRG) data. We compared The Cleveland Clinic's Inpatient Palliative Medicine (CCIPM) acute care unit's CMI and APR-DRG data with national and peer institution data. Total mean charges per admission to the CCIPM unit were 7,800 dollars lower than at other peer institutions despite an equivalent severity of illness and longer length of stay and higher mortality in the CCIPM unit. The lower charges were due primarily to lower laboratory and pharmaceutical charges. We conclude that an acute inpatient palliative medicine unit operating within a comprehensive integrated palliative medicine program is cost-effective in providing specialized care for people with advanced disease.
authors.affiliation: The Harry R. Horvitz Center for Palliative Medicine, The Cleveland Clinic Taussig Cancer Center, OH, USA.
authors.forename: Mellar P
authors.initials: MP
authors.lastname: Davis
authors.forename: Declan
authors.initials: D
authors.lastname: Walsh
authors.forename: Susan B
authors.initials: SB
authors.lastname: LeGrand
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Lagman
authors.forename: Betty
authors.initials: B
authors.lastname: Harrison
authors.forename: Lisa
authors.initials: L
authors.lastname: Rybicki
mesh_terms: D000208:Acute Disease; D003362:Cost-Benefit Analysis; D003953:Diagnosis-Related Groups; D016527:Drug Costs; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D009369:Neoplasms / Q000191:economics* / Q000628:therapy*; D010166:Palliative Care / Q000191:economics*; D012720:Severity of Illness Index