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American Academy of Family Physicians
American Academy of Family Physicians
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Palliative Care: Can we really improve quality, save money and prolong life? Timothy E. Quill M.D. Center for Ethics, Humanities and Palliative Care University of Rochester Medical Center
Financial Disclosure Statement ,[object Object]
Palliative Care: A Definition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
As Illness Progresses… An Increasing Emphasis on Palliation
Age Distribution of US population 10,000 people/day http://www:metlife.com
 
 
 
Where more can be less
Regional Variation in Health Care costs Fisher,E. NEJM 2-26-09 5% 4% 3% 2.4%
Regional Variation in Health Care Costs ,[object Object],[object Object],[object Object],[object Object]
Spending at the EOL ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Health Care Costs in the Last week of Life: Associations with EOL Conversations ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Two Recent Palliative Care Studies Relevant to Cost, Quality, and Mortality
Early Palliative Care for Patients with Metastatic Non-Small-Cell Lung Cancer Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ N Engl J Med 2010 363:733-42
Methods ,[object Object],[object Object],[object Object],[object Object]
Key Findings: QOL and Mood ,[object Object],[object Object],[object Object],[object Object],[object Object]
Key Findings: End-of-Life Care ,[object Object],[object Object],[object Object],[object Object]
Key Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Palliative Care Consultation Teams Cut Hospital Costs For Medicaid Beneficiaries R. Sean Morrison, Jessica Dietrich, Susan Ladwig, Timothy Quill, Joseph Sacco, John Tangeman, Diane E. Meier Health Affairs 2011;30:454-453
Methods ,[object Object],[object Object],[object Object],[object Object],[object Object]
Palliative Care and Cost Outcomes ,[object Object]
Cost/Day For Patients Discharged Alive
Implications ,[object Object],[object Object],[object Object]
Bottom Line ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Primary vs Specialty Palliative Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
References ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Quill eol policy

  • 1. Palliative Care: Can we really improve quality, save money and prolong life? Timothy E. Quill M.D. Center for Ethics, Humanities and Palliative Care University of Rochester Medical Center
  • 2.
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  • 4. As Illness Progresses… An Increasing Emphasis on Palliation
  • 5. Age Distribution of US population 10,000 people/day http://www:metlife.com
  • 6.  
  • 7.  
  • 8.  
  • 9. Where more can be less
  • 10. Regional Variation in Health Care costs Fisher,E. NEJM 2-26-09 5% 4% 3% 2.4%
  • 11.
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  • 15.  
  • 16. Two Recent Palliative Care Studies Relevant to Cost, Quality, and Mortality
  • 17. Early Palliative Care for Patients with Metastatic Non-Small-Cell Lung Cancer Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ N Engl J Med 2010 363:733-42
  • 18.
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  • 22. Palliative Care Consultation Teams Cut Hospital Costs For Medicaid Beneficiaries R. Sean Morrison, Jessica Dietrich, Susan Ladwig, Timothy Quill, Joseph Sacco, John Tangeman, Diane E. Meier Health Affairs 2011;30:454-453
  • 23.
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  • 25. Cost/Day For Patients Discharged Alive
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  • 29.