title: Cost Savings Associated With an Inpatient Palliative Care Unit: Results From the First Two Years.
abstract: BACKGROUND
  Palliative care consultation services (PCCS) decrease costs for patients by matching treatments received to patients' and families' goals of care. However, few studies have examined the costs of a specialized palliative care unit (PCU).
  
  
  OBJECTIVE
  To quantitatively describe Mount Sinai Hospital's PCU's first two years of operation; to examine how patient-related costs changed in the days before and after transfer to PCU; and to compare cost savings of PCU to those of PCCS.
  
  
  METHODS
  Cost and administrative data from PCU patients from the first 24.5 months of our PCU's operation were analyzed. To compare costs between PCU and PCCS patients, we matched PCU patients to similar PCCS patients and used propensity scores to adjust for differences across groups.
  
  
  RESULTS
  The PCU admitted 1107 patients in its first 24.5 months. Over this time frame, there was a statistically significant (P < 0.001) decrease in average daily direct costs per patient. The mean of patients' average cost per day was $687 less while on the PCU than before transfer to PCU. Among patients who died in the hospital, average daily direct cost per patient in the days after transfer to PCU was $240 lower as compared with patients being followed by PCCS on the general hospital wards (SE = $45, P < 0.001).
  
  
  CONCLUSIONS
  Among patients who died in the hospital, transfer to a PCU is associated with significant cost savings as compared with patients on hospital wards who are seen by a PCCS.
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Nathaniel
authors.affiliation: Geriatrics Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA; Lilian and Benjamin Hertzberg Palliative Care Institute of the Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Garrido
authors.affiliation: Lilian and Benjamin Hertzberg Palliative Care Institute of the Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Chai
authors.affiliation: Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Goldberg
authors.affiliation: Geriatrics Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA; Lilian and Benjamin Hertzberg Palliative Care Institute of the Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: nathan.goldstein@mssm.edu.
authors.forename: Nathan E
authors.initials: NE
authors.lastname: Goldstein
mesh_terms: D000368:Aged; D017046:Cost Savings / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D010166:Palliative Care / Q000191:economics* / Q000379:methods* / Q000706:statistics & numerical data; D013997:Time Factors
keywords: Palliative medicine; cost; cost savings; longitudinal study; palliative care unit