1. Association Between Palliative Case Management and Utilization of Inpatient, Intensive Care Unit, Emergency Department, and Hospice in Medicaid Beneficiaries
- Author
-
Lin Wang, Leslie Piet, Sydney M. Dy, and Catherine M. Kenworthy
- Subjects
Male ,medicine.medical_specialty ,Palliative care ,Critical Care ,law.invention ,law ,Humans ,Medicine ,In patient ,Retrospective Studies ,Terminal Care ,Medicaid ,business.industry ,Palliative Care ,Retrospective cohort study ,Health Care Costs ,General Medicine ,Emergency department ,Middle Aged ,Case management ,Intensive care unit ,United States ,Icu admission ,Hospitalization ,Hospice Care ,Emergency medicine ,Female ,Emergency Service, Hospital ,business ,Case Management - Abstract
Association between palliative case management (PCM) and the utilization of major health services during the last 30 days of life in Medicaid patients with cancer was assessed using retrospective cohort analysis. There were 132 PCM enrollees in the intervention group and 54 non-PCM enrollees in the comparison group. The intervention group had lower inpatient admission rate than that of the comparison group (56.8% vs 74.1%), lower ICU admission rate (12.9% vs 24.1%), longer mean hospice days (45.8 vs 31.1 days), and lower percentage of persons with death in hospital (24.2% vs 35.9%). No statistically significant differences were found in mean intensive care unit days (8.7 vs 9.7 days), treat-and-release emergency department visit rate (22.0% vs 16.7%), or hospice election rate (65.9% vs 70.4%). Palliative case management may reduce hospitalization and increase hospice use in patients nearing death.
- Published
- 2014
- Full Text
- View/download PDF