Cost impact of introducing a treatment escalation/limitation plan during patients' last hospital admission before death.

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
Janet BouttellDouglas Robin Taylor

Abstract

A recent study found that the use of a treatment escalation/limitation plan (TELP) was associated with a significant reduction in non-beneficial interventions (NBIs) and harms in patients admitted acutely who subsequently died. We quantify the economic benefit of the use of a TELP. NBIs were micro-costed. Mean costs for patients with a TELP were compared to patients without a TELP using generalized linear model regression, and results were extrapolated to the Scottish population. Medical, surgical and intensive care units of district general hospital in Scotland, UK. Two hundred and eighty-seven consecutive patients who died over 3 months in 2017. Of these, death was 'expected' in 245 (85.4%) using Gold Standards Framework criteria. Treatment escalation/limitation plan. Between-group difference in estimated mean cost of NBIs. The group with a TELP (n = 152) had a mean reduction in hospital costs due to NBIs of GB £220.29 (US $;281.97) compared to those without a TELP (n = 132) (95% confidence intervals GB £323.31 (US $413.84) to GB £117.27 (US $150.11), P = <0.001). Assuming that a TELP could be put in place for all expected deaths in Scottish hospitals, the potential annual saving would be GB £2.4 million (US $3.1 million) fro...Continue Reading

References

Mar 25, 2000·JAMA : the Journal of the American Medical Association·D W MolloyS Dubois
Jul 27, 2001·Journal of Health Economics·W G Manning, J Mullahy
Nov 11, 2005·The Milbank Quarterly·Avedis Donabedian
Mar 13, 2008·Journal of Palliative Medicine·Glenn GadeRichard Della Penna
Mar 11, 2009·Archives of Internal Medicine·Baohui ZhangHolly G Prigerson
Oct 6, 2011·JAMA : the Journal of the American Medical Association·Lauren Hersch NicholasDavid R Weir
Jan 1, 2012·Journal of Health Care for the Poor and Underserved·James FonkNancy Mathiowetz
Nov 15, 2013·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Toshitaka MorishimaYuichi Imanaka
Mar 19, 2014·Palliative Medicine·David ClarkChristopher Isles
Jul 8, 2014·The Journal of the Royal College of Physicians of Edinburgh·P A Levack
Jun 11, 2015·Palliative Medicine·Josie DixonMartin Knapp
Feb 24, 2016·Journal of Pain and Symptom Management·Melissa M GarridoPaul K Maciejewski
Jun 30, 2016·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·M Cardona-MorrellK Hillman
Jan 13, 2017·Lancet·Shannon BrownleeDeborah Korenstein
Jul 2, 2017·BMC Health Services Research·Joelle Robertson-PreidlerTricia J Johnson
Feb 27, 2018·Postgraduate Medical Journal·D Robin Taylor, Calvin J Lightbody
May 11, 2019·The American Journal of Hospice & Palliative Care·Lauren T StarrSalimah H Meghani

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