When a patient is not ready to face their end-of-life or to be admitted into hospice care, the traditional hospital model gives little option for how to bridge the gap in care for them. Over the last five years, Palliative Care has increased in the healthcare market as a key answer to this need. This specialty provides the patient with symptom management, assistance with self-directed decision making, and coordination with multiple healthcare providers, even while the patient is pursuing curative therapies.The Palliative Care field is still relatively small in Florida compared to other states, but is growing rapidly. Palliative Care specialists have the tools to solve problems of pain and discomfort – especially when the symptom management is complex.
So what exactly is the difference between hospice and palliative care? Palliative Care is appropriate for patients with serious, life-limiting illness from the time of diagnosis and throughout the course of the disease. There is no limitation on the life expectancy of the patient, pursuit of curative therapies, or the duration of service. Hospice care often starts weeks, months, or even years later, since eligibility requires that the patient have a terminal disease with a life expectancy of six months or less if the disease runs its expected course.
Hospice and Palliative Care addresses a serious need in the hospital setting: to reduce readmissions for patients who are faced with a terminal illness but not receiving regular care at home. For the hospital physician, a Palliative Care consultation can assist you in presenting your patient with options for goals of care, complex symptom management treatment and advanced directive care planning. At Hospice of Palm Beach County and Hospice of Broward County, we have a medical group called South Florida Palliative Medicine Specialists (SFPMS). These specialists often spend hours with a patient, slowly bringing them to that “light bulb” moment where they understand the ways their symptoms are interacting, and how to address them to improve quality of life. Approximately 83% of patients seen by our palliative medicine specialists end up choosing the Hospice Medicare Benefit for end-of-life care. This transfers the mortality statistic, an outcome measure for hospitals, to the hospice. A significant number of patients, who continue with acute care options, achieve better symptom control and quality of life when under the care of a Palliative Care physician.
Also of interest is the cost savings to a hospital. In a study seen in Archives of Internal Medicine/Vol 168 (No. 16), six doctors analyzed eight hospitals between the years of 2002-2004. They studied the cost savings to a hospital by using palliative care specialists rather than a traditional acute care model for treatment and subsequent discharge of the patient. Of particular interest in this study was the mortality rate. Compared with traditional patients who died under the hospital’s care, the palliative care patients who died had $374 direct costs savings per patient per day, totaling up to an adjusted $4,908 direct costs savings per admission. These included significant reductions in pharmacy, laboratory, and intensive care units costs.
South Florida Palliative Medicine Specialists physicians are board certified in Hospice and Palliative Care, making them the largest group of certified specialists in South Florida. We also have a post-graduate medical training program that educates the next generation of specialists.
Locally, SFPMS has established programs with several hospitals, with good success. Our Hospice and Palliative Care programs contributed to one local hospital attaining the distinction of America’s 50 Best Hospitals identified by HealthGrades for the last 5 years. A Palliative Care program provides significant cost savings, lower readmission rates, and the best possible care for hospitalized patients.
