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Does a palliative care consult decrease the cost of caring for hospitalized patients with dementia?

Published online by Cambridge University Press:  21 October 2013

Marissa Araw ,
Andrzej Kozikowski ,
Cristina Sison ,
Tanveer Mir ,
Maha Saad ,
Lauren Corrado ,
Renee Pekmezaris  and
Gisele Wolf-Klein
Marissa Araw
Affiliation:
North Shore–Long Island Jewish Health System, Great Neck, New York
Andrzej Kozikowski
Affiliation:
North Shore–Long Island Jewish Health System, Great Neck, New York
Cristina Sison
Affiliation:
Feinstein Institute for Medical Research, Manhasset, New York
Tanveer Mir
Affiliation:
North Shore–Long Island Jewish Health System, Great Neck, New York Long Island Jewish Medical Center, New Hyde Park, New York
Maha Saad
Affiliation:
North Shore–Long Island Jewish Health System, Great Neck, New York St. Johns University College of Pharmacy and Health Sciences, Queens, New York Long Island Jewish Medical Center, New Hyde Park, New York
Lauren Corrado
Affiliation:
North Shore–Long Island Jewish Health System, Great Neck, New York Long Island Jewish Medical Center, New Hyde Park, New York
Renee Pekmezaris*
Affiliation:
North Shore–Long Island Jewish Health System, Great Neck, New York Albert Einstein College of Medicine, Bronx, New York Hofstra North Shore–Long Island Jewish School of Medicine, Hempstead, New York
Gisele Wolf-Klein
Affiliation:
North Shore–Long Island Jewish Health System, Great Neck, New York Albert Einstein College of Medicine, Bronx, New York Hofstra North Shore–Long Island Jewish School of Medicine, Hempstead, New York
*
Address correspondence and reprint requests to: Renee Pekmezaris, North Shore–Long Island Jewish Health System, 175 Community Drive, Second Floor, Great Neck, New York 11021. E-mail: rpekmeza@nshs.edu
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Abstract

Objective:

Advanced dementia (AD) is a terminal disease. Palliative care is increasingly becoming of critical importance for patients afflicted with AD. The primary objective of this study was to compare pharmacy cost before and after a palliative care consultation (PCC) in patients with end-stage dementia. A secondary objective was to investigate the cost of particular types of medication before and after a PCC.

Method:

This was a retrospective study of 60 hospitalized patients with end-stage dementia at a large academic tertiary care hospital from January 1, 2010 to October 1, 2011, in order to investigate pharmacy costs before and after a PCC. In addition to demographics, we carried out a comparison of the average daily pharmacy cost and comparison of the proportion of subjects taking each medication type (cardiac, analgesics, antibiotics, antipsychotics and antiemetics) before and after a PCC.

Results:

There was a significant decrease in overall average daily pharmacy cost from before to after a PCC ($31.16 ± 24.71 vs. $20.83 ± 19.56; p < 0.003). There was also a significant difference in the proportion of subjects taking analgesics before and after PCC (55 vs. 73.3%; p < 0.009), with a significant average daily analgesic cost rise from pre- to post-PCC: $1.36 ± 5.07 (median = $0.05) versus. $2.35 ± 5.35 (median = $0.71), respectively, p < 0.011; average daily antiemetics cost showed a moderate increase from pre- to post-PCC: $0.08 ± 0.37 (median = $0) versus $0.23 ± 0.75 (median = $0), respectively, p < 0.047.

Significance of results:

Our findings indicate that PCC is associated with overall decreased medication cost in hospitalized AD patients. Additionally, receiving a PCC was related to greater use of pain medications in hospitalized dementia patients. Our study corroborates the benefits of palliative care team intervention in managing elderly hospitalized dementia patients.

Keywords

Palliative Care ConsultEnd-of-lifeDementiaPharmacy Costs

Information

Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 6 , December 2015 , pp. 1535 - 1540
Copyright
Copyright © Cambridge University Press 2013 

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