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The business of palliative medicine—Part 4: Potential impact of an acute-care palliative medicine inpatient unit in a tertiary care cancer center

The Harry R. Horvitz Center for Palliative Medicine (A World Health Organization Demonstration Project), Cleveland Clinic Foundation, Cleveland, Ohio

In this study, a hematology/oncology computerized discharge database was qualitatively and quantitatively reviewed using an empirical methodology. The goal was to identify potential patients for admission to a planned acute-care, palliative medicine inpatient unit. Patients were identified by the International Classifications of Disease (ICD-9) codes. A large heterogenous population, comprising up to 40 percent of annual discharges from the Hematology/Oncology service, was identified. If management decided to add an acute-care, palliative medicine unit to the hospital, these are the patients who would benefit. The study predicted a significant change in patient profile, acuity, complexity, and resource utilization in current palliative care services. This study technique predicted the actual clinical load of the acute-care unit when it opened and was very helpful in program development. Our model predicted that 695 patients would be admitted to the acute-care palliative medicine unit in the first year of operation; 655 patients were actually admitted during this time.

Key Words: cancer • ICD-9 code • palliative medicine • costs • inpatient • end of life

American Journal of Hospice and Palliative Medicine®, Vol. 21, No. 3, 217-221 (2004)
DOI: 10.1177/104990910402100312


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