Understanding CMS’s Proposed Rule Regarding Prior Authorization For Drugs
LDI Expert Considers Cost, Quality, and Access Implications
Blog Post
Chart of the Day: Default Orders Increased Palliative Care Consultations But Did Not Shorten Hospital Stays for Older Patients
Study Shows a Simple Intervention Improves End-Of-Life Care for Seriously Ill Patients
Print:
Palliative care consultation is recommended for patients with serious illnesses, but many aren’t referred for this care or only receive a consultation at the end of their lives. To test whether a simple intervention would improve palliative care consultation rates and outcomes as measured by length of stay in the hospital, LDI Senior Fellows Katherine Courtright, Scott Halpern, Dylan Small, Mary Ersek and their team conducted a multisite randomized trial that included over 24,000 patients.
The study, published in JAMA, randomized hospitalized patients 65 years or older with serious illnesses (advanced chronic obstructive pulmonary disease [COPD], dementia, or kidney failure) to have default orders for palliative care added to their charts or usual care. Among the patients with default orders in their charts, 43.9% received a consult compared to 16.6% who did not. In addition, patients in the intervention group who received a consultation received it more quickly. While there was no significant difference (4.9 versus 5 days) in the length of stay between the two groups, the study demonstrated that a default order in patients’ charts improves end-of-life care for seriously ill patients.
The study, “Default Palliative Care Consultation for Seriously Ill Hospitalized Patients: A Pragmatic Cluster Randomized Trial,” was published on January 16, 2024 in JAMA. Authors include Katherine R. Courtright, Vanessa Madden, Brian Bayes, Marzana Chowdhury, Casey Whitman, Dylan S. Small, Michael O. Harhay, Suzanne Parra, Elizabeth Cooney-Zingman, Mary Ersek, Gabriel J. Escobar, Sarah H. Hill, and Scott D. Halpern.
Author
Christine Weeks
Director, Strategic Initiatives
More on Health Care Access & Coverage
Congress is Fighting the Wrong Pharmacy Battle
Better Plan Choices Would Lower Drug Costs, Not PBM Breakups, LDI’s Mark Pauly Says
Why Some Family Health Insurance Is Now Much Pricier
LDI Expert Proposes Fixes to Keep Marketplace Plans Within Families’ Budgets
Despite Coverage Requirements, Insurers Added Barriers to Access for Drugs
Chart of the Day: Medicare, Medicaid, and Insurers Replaced High Costs With More Hurdles, LDI Expert Finds
Cost Plus Drugs Beats Health Insurance for High-Cost Generics
Chart of the Day: Mark Cuban’s Cost Plus Drugs Can Save Employer-Covered Patients Hundreds on Some Generics
Debate Continues Over H.R. 1 Medicaid Changes as Millions Risk Losing Coverage
Will Implementation Create Sweeping Losses or a Return to Balance and Self-Sufficiency?