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

https://doi.org/10.1136/ebn.11.1.22

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    S Enguidanos

    Correspondence to: Dr S Enguidanos, Partners in Care Foundation, San Fernando, CA, USA; senguidanos@picf.org

    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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    Footnotes

    • Source of funding: Kaiser Permanente Garfield Memorial Fund.