Home-based palliative care study: site of death, and costs of medical care for patients with congestive heart failure, chronic obstructive pulmonary disease, and cancer.
OBJECTIVE
To examine differences in site of death and costs of services by primary diagnosis for patients receiving home-based palliative care as compared to usual care at the end of life.


METHODS
A nonequivalent group design was employed with 298 terminally ill patients diagnosed with cancer, CHF, or COPD enrolled. The treatment group received an interdisciplinary home-based palliative care program and the comparison group received usual Kaiser Permanente services. Data collected included patient demographics, severity of illness, service use, and site of death.


RESULTS
Among all diseases, patients enrolled in palliative care were more likely to die at home. Enrollment in palliative care was significant associated with cost reductions for patients with cancer, COPD, and CHF. No significant difference was found between diagnostic groups in terms of magnitude of cost savings.


CONCLUSIONS
Provision of interdisciplinary home-based palliative care at end of life can effectively increase the likelihood of dying at home for patients with CHF, COPD, and cancer while realizing significant cost savings.
Enguidanos
Susan Milena
SM
Partners in Care Foundation, 101 South First Street, Burbank, CA 91502, USA. sengui@aol.com
Cherin
David
D
Brumley
Richard
R
D000368:Aged; D003643:Death; D005260:Female; D005102:Health Expenditures; D006333:Heart Failure / Q000191:economics*; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics*; D010166:Palliative Care / Q000191:economics*; D010348:Patient Care Team; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics*; D012720:Severity of Illness Index; D013727:Terminal Care / Q000191:economics