Estimated economic impact of implementing exclusive palliative care in an intensive care unit / Impacto económico estimado da implementação de cuidados paliativos exclusivos numa unidade de cuidados intensivos

Abstract

Palliative care (PC) is a modality of care for patients with no possibility of cure for a disease or terminally ill. The objective of this care model is to provide integral care to the patient and their family, involving the multidisciplinary team in caring, in addition to pursuing strategies so that the interventions conducted promote comfort and well-being for those involved. This is a retrospective cross-sectional study in which the total expenses and per day of hospitalization with exams and medications of patients before and after being included in the PC protocol of the institution were evaluated. All patients who met the inclusion criteria in the PC protocol and were likely to change the therapeutic focus to exclusive PC, oncologic and non-oncologic, were included. The study proved to be extremely relevant in the quantitative comparison of costs in adult ICU before and after PC, showing a reduction regarding cost/day with exams and medications of 95% and 44% respectively, and mean hospital stay was reduced from 14 to 6 days. It is noteworthy that 16% of those patients did not die in the ICU environment, representing a possible humanization of care and improvement in the quality of visits and family interaction. The results of this study indicate a significant decrease in costs with the correct implementation of exclusive PC, supporting the need for introduction of protocols and earlier and more comprehensive insertion of patients in PC.