title: The business of palliative medicine - part 5: service utilization in a comprehensive integrated program.
abstract: The aim of palliative medicine is to provide multidisciplinary comprehensive care in advanced illness. Patient and family utilization of various product service lines offered by the Harry R Horvitz Center for Palliative Medicine at the Cleveland Clinic Foundation was studied. Newly referred patients were followed up prospectively until 85% had either died or been lost to follow-up. Demographic, clinical, and referral data were recorded; subsequent product service line utilization was updated daily. The total study period was 171 days, and 238 patients entered. Acute care inpatient unit, outpatient clinic visits, and 24-hour phone contacts were the most frequently used product service lines. Patients had a median of 3 contacts (range, 1 to 27) with individual service lines. Multiple palliative medicine product service lines were utilized often, with repeated use of the individual service lines. A comprehensive integrated palliative medicine program is necessary to fully meet the complex needs of those with advanced disease.
authors.affiliation: Harry R Horvitz Center for Palliative Medicine, The Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: Bassam
authors.initials: B
authors.lastname: Estfan
authors.forename: Mellar P
authors.initials: MP
authors.lastname: Davis
authors.forename: Declan
authors.initials: D
authors.lastname: Walsh
authors.forename: Jessica
authors.initials: J
authors.lastname: Heintz
authors.forename: Philip E
authors.initials: PE
authors.lastname: Shaheen
authors.forename: Bushra
authors.initials: B
authors.lastname: Cheema
authors.forename: Susan B
authors.initials: SB
authors.lastname: LeGrand
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Lagman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019033:Delivery of Health Care, Integrated; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009820:Ohio; D010166:Palliative Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D016730:Program Development; D011446:Prospective Studies; D012017:Referral and Consultation; D015996:Survival Rate