We celebrate the blessed birth of an individual though we are equally aware of the inevitability of death. However, many people are uncomfortable even talking about death or the quality of end of life. Thus when the topic of end-of-life care arises, most of us are tongue-tied and bewildered. The issue of attaining a balance between care, quality of life, and cost for end-of-life patients continues to baffle practitioners and policy makers as well as patients and their families.
Dartmouth study on end-of-life care
The quandary faced by many is whether to continue aggressive treatment therapies and medical intervention or to opt for peaceful death at home without machines and medications. Also, these types of medical interventions, including hospitalization, intensive care units, and rounds of tests and medication, are costly. In addition, they often fail to alter the patient’s condition and rarely prolong life. A Dartmouth study has found that there is a lack of a uniform protocol across the country for end-of-life care and course of treatment. In fact, according to this study, US healthcare resources and medi-claim funds are being spent on aggressive end-of-life care, with little positive outcome. So, the question that arises is how to save money on end-of-life care.
Saving money on end-of-life care
Before considering how to save money that is spent on end-of-life care and treatment, it should be taken into consideration what the patient’s wishes are and whether he wants to spend his last days surrounded by machines and monitors or in the company of family and friends. Many wish for a peaceful death, but often end up breathing their last in a hospital, as the high quality of modern end-of-life care often prolongs life against the wishes of the patient and also protracts pain after the patient has already undergone aggressive intervention; these types of measures also increase the overall cost of medicare. The solution to this is palliative care, which results in enhancing the well-being of the patient and saving money as well.
Palliative care is an interdisciplinary specialty that seeks to improve the quality of life of those suffering from advanced and terminal illnesses. Palliative care can be administered at special palliative centers in hospitals, at hospice facilities, or at home. It also focuses on using traditional therapies to improve well-being of the patient apart from managing pain and symptoms of their respective illnesses. Studies have shown that palliative care manages to do that with the help of qualified coordinators and nurses and has even resulted in shorter intensive care unit stay for the patient. With palliative care the use of intensive interventions is limited and thus the quality of life improves for end-of-life patients and medicare cost is saved.
Save money through palliative care
Data from a Dartmouth study reveals that those under palliative care had fewer hospital stays and the cost of end-of-life care was lower by almost 16% compared to normal treatment. Those opting for end-of-life care at home or palliative centers saved approximately $2400 for 7 days of treatment compared to hospitalization, and the amount increases as the number of days increases.
The need is for doctors and the medical team to take it upon themselves to initiate discussions with patients and their families, and direct them towards palliative care instead of prolonging pain through further interventions. Also, the number of such palliative facilities needs to increase. Hence palliative care that offers coordinated end-of-life care can improve patient well-being and result in cost savings too.