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American Journal of Hospice and Palliative Medicine®, Vol. 23, No. 3, 212-216 (2006)
DOI: 10.1177/1049909106289083

A Cost Comparison of Hospice Care in Amyotrophic Lateral Sclerosis and Lung Cancer

Lauren B. Elman, MD

University of Pennsylvania, Philadelphia, Pennsylvania

Lisa Stanley, RN

Wissahickon Hospice of the University of Pennsylvania, Bala Cynwyd, Pennsylvania

Patricia Gibbons

Wissahickon Hospice of the University of Pennsylvania, Bala Cynwyd, Pennsylvania

Leo McCluskey, MD, MBE

University of Pennsylvania, Philadelphia, Pennsylvania, lfmcclusky{at}pahosp.com

The authors compare the cost of hospice care provided to 25 amyotrophic lateral sclerosis (ALS) patients and 159 lung cancer patients by the Wissahickon Hospice of the University of Pennsylvania. The mean length of stay was 86.7 days for ALS patients and 35.0 days for patients with lung cancer (P = .011). The mean per patient cost was $5622.93 for the ALS patients and $2658.91 for patients with lung cancer (P = .057) The average operating margin excluding administrative costs was $5293.04 for ALS patients and $2126.74 for patients with lung cancer (P = .008). The longer length of stay (LOS) accounts for this difference. Longer LOS can be accomplished by close clinical monitoring of ALS patients for the development of life threatening respiratory and/or nutritional compromise and by liberalizing the present hospice admission guidelines.

Key Words: amyotrophic lateral sclerosis • lung cancer • hospice • cost


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