The business of palliative medicine - part 5: service utilization in a comprehensive integrated program.
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.
Estfan
Bassam
B
Harry R Horvitz Center for Palliative Medicine, The Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Davis
Mellar P
MP
Walsh
Declan
D
Heintz
Jessica
J
Shaheen
Philip E
PE
Cheema
Bushra
B
LeGrand
Susan B
SB
Lagman
Ruth L
RL
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