title: Outcomes of the acute palliative care unit in an academic medical center.
abstract: BACKGROUND
  The acute palliative care units (APCU) where the palliative medicine specialists are primarily in charge with medical management are being established in few academic medical centers. The purpose of this study is to review the demographics and outcomes of the APCU admissions and the economical implications to the Montefiore Medical Center, Bronx, New York.
  
  
  METHODS
  We retrospectively examined the demographics, diagnosis related groups (DRGs), length of hospital stay (LOS), discharge status and hospital charge data using data from intcernal cost accounting databases for consecutive admissions to the palliative care unit between February 2007 and February 2010.
  
  
  RESULTS
  A total of 1837 patients were admitted. Six hundred eighty patients transferred from other medical-surgical units. Twenty two percent of the patients were admitted under other specialties but co-managed with the palliative medicine specialists. The top three DRGs were sepsis without or with mechanical ventilation and heart failure with major co-morbidities. The average length of stay was comparable to other medical surgical units. Seventy-two percent of the patients were discharged alive, 27% died in the hospital. The median charges were lower in the palliative care unit than in medical-surgical units (p<.0001). These benefits were more likely to occur if patients were managed directly by the specialists.
  
  
  CONCLUSIONS
  Our data suggests that the APCU may provide cost effective, acute care for the patients with advanced chronic illness as well as the imminently dying in need of intensive symptom management.
authors.affiliation: 1Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Serife
authors.initials: S
authors.lastname: Eti
authors.forename: Sean
authors.initials: S
authors.lastname: O'Mahony
authors.forename: Marlene
authors.initials: M
authors.lastname: McHugh
authors.forename: Rose
authors.initials: R
authors.lastname: Guilbe
authors.forename: Arthur
authors.initials: A
authors.lastname: Blank
authors.forename: Peter
authors.initials: P
authors.lastname: Selwyn
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000208:Acute Disease / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055815:Young Adult
keywords: DRGs(diagnosis-related groups); acute palliative care unit; economical implications; length of stay; outcome evaluation; palliative care