Impact of an inpatient palliative care team: a randomized control trial

J Palliat Med. 2008 Mar;11(2):180-90. doi: 10.1089/jpm.2007.0055.


Background: Palliative care improves care and reduces costs for hospitalized patients with life-limiting illnesses. There have been no multicenter randomized trials examining impact on patient satisfaction, clinical outcomes, and subsequent health care costs.

Objective: Measure the impact of an interdisciplinary palliative care service (IPCS) on patient satisfaction, clinical outcomes, and cost of care for 6 months posthospital discharge.

Methods: Multicenter, randomized, controlled trial. IPCS provided consultative, interdisciplinary, palliative care to intervention patients. Controls received usual hospital care (UC).

Setting and sample: Five hundred seventeen patients with life-limiting illnesses from a hospital in Denver, Portland, and San Francisco enrolled June 2002 to December 2003.

Measures: Modified City of Hope Patient Questionnaire, total health care costs, hospice utilization, and survival.

Results: IPCS reported higher scores for the Care Experience scale (IPCS: 6.9 versus UC: 6.6, p = 0.04) and for the Doctors, Nurses/Other Care Providers Communication scale (IPCS: 8.3 versus UC: 7.5, p = 0.0004). IPCS patients had fewer intensive care admissions (ICU) on hospital readmission (12 versus 21, p = 0.04), and lower 6-month net cost savings of $4,855 per patient (p = 0.001). IPCS had longer median hospice stays (24 days versus 12 days, p = 0.04). There were no differences in survival or symptom control.

Conclusions: IPCS patients reported greater satisfaction with their care experience and providers' communication, had fewer ICU admissions on readmission, and lower total health care costs following hospital discharge.

Trial registration: NCT00325611.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Advance Directives / statistics & numerical data
  • Aged
  • Cooperative Behavior
  • Critical Illness / epidemiology
  • Critical Illness / psychology
  • Critical Illness / rehabilitation
  • Hospice Care / statistics & numerical data
  • Hospitalization* / statistics & numerical data
  • Humans
  • Palliative Care / methods*
  • Patient Care Team*
  • Patient Satisfaction
  • Prospective Studies
  • Quality of Life / psychology
  • Survival Rate

Associated data