Embedded hospital primary palliative care that was led by social workers and nurse practitioners had better patient outcomes than referral-based specialty palliative care, a recent study found.
The study, published Feb. 17 in Journal of Palliative Medicine, analyzed data from adults who received palliative care consults at a New York City academic medical center. Data was collected between March 2019 to February 2020 and June 2021 to May 2022. Researchers compared patients who received hospital primary palliative care or specialty palliative care across metrics including comorbidities, mortality index, ICU admissions, length of stay, discharge disposition and 30-day readmissions.
Here are four study findings.
1. The hospital primary palliative care group had lower ICU admission rates at 13.2% and 13.6% in the two study periods, respectively, compared to the specialty care group which had ICU admissions of 41.1% and 46.2%, respectively.
2. The median length of stay for HPPC patients was 18.2 and 21 days, respectively, compared to 21.3 and 24.5 days, respectively, for the SPC group.
3. Patients in the HPPC group were more often discharged to home or to a facility, and were more likely to have documented life-prolonging goals of care, compared to those in SPC.
4. Readmission rates at 30 days, hospice enrollment and mortality rates were similar between the groups.
“An embedded [social worker/nurse practitioner]-led palliative care model in hospital medicine improves access, reduces acute care use and is sustainable over time,” the study authors wrote. “This approach supports timely, culturally sensitive, needs-based palliative care and may be scalable for hospital-based delivery.”
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