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In-home palliative care increased patient satisfaction and reduced use and costs of medical services

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S Enguidanos

Correspondence to: Dr S Enguidanos, Partners in Care Foundation, San Fernando, CA, USA; [email protected]

QUESTION

Does an in-home palliative care (IHPC) programme plus usual care increase patient satisfaction and reduce use and costs of medical services compared with usual care alone?

METHODS

Design:

randomised controlled trial.

Allocation:

concealed.

Blinding:

blinded (data collectors).

Follow-up period:

to death or end of study period.

Setting:

2 health maintenance organisations in Hawaii and Colorado, USA.

Patients:

310 patients (mean age 74 y, 51% men) who had a primary diagnosis of congestive heart failure, chronic obstructive pulmonary disease, or cancer; had a life expectancy ⩽12 months; had visited the emergency department (ED) or hospital within the previous year; and scored ⩽70% on the Palliative Performance Scale.

Intervention:

IHPC plus usual care (n = 155) or usual care alone (n = 155). IHPC was provided by an interdisciplinary team including the patient and …

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