The impact of a palliative care service on overall hospital mortality in a comprehensive cancer center

Abstract

8034 Background: Dying in a hospital, particularly on an intensive care unit (ICU), can be traumatic for patients and families. Palliative care services (PCS) and a palliative care unit (PCU) improve severe physical and psychosocial symptoms, but they are not available in the majority of cancer centers and tertiary hospitals. The purpose of this paper is to review the impact of a PCS/PCU on overall hospital mortality at the University of Texas M.D. Anderson Cancer Center. Methods: We reviewed inpatient hospital deaths (including number of deaths, hospital location of death, and medical service), hospital discharges, and medical service information from the years 1999–2003. We determined the number of patients who accessed PCS before death (via consults or PCU admission). The Cochran-Armitage Trend Test was used to test for trends over time. Results: See table below. Conclusions: Establishment of PCS and PCU resulted in no significant increase in hospital mortality or length of stay. Coordinated efforts between PCS, ICU, and an ethics consult service resulted in a decrease in ICU deaths. By 2003, PCS had increased significantly. No significant financial relationships to disclose.