Title

Moving Upstream: A Review of the Evidence of the Impact of Outpatient Palliative Care

Publication/Presentation Date

12-2013

Abstract

BACKGROUND:

There is good evidence for the efficacy of inpatient palliative care in improving clinical care, patient and provider satisfaction, quality of life, and health care utilization. However, the evidence for the efficacy of nonhospice outpatient palliative care is less well known and has not been comprehensively reviewed.

OBJECTIVE:

To review and assess the evidence of the impact of outpatient palliative care.

METHODS:

Our study was a review of published, peer-reviewed outcomes research, including both observational studies and controlled trials of nonhospice outpatient palliative care services. We assessed patient, family caregiver, and clinician satisfaction; clinical outcomes including symptom management, quality of life, and mortality; and heath care utilization outcomes including readmission rates, hospice use, and cost.

RESULTS:

Four well-designed randomized interventions as well as a growing body of nonrandomized studies indicate that outpatient palliative care services can: 1) improve patient satisfaction, 2) improve symptom control and quality of life, 3) reduce health care utilization, and 4) lengthen survival in a population of lung cancer patients.

CONCLUSIONS:

The available evidence supports the ongoing expansion of innovative outpatient palliative care service models throughout the care continuum to all patients with serious illness.

Volume

16

Issue

12

Comments

The paper was e-published in JPM 11/13/13

Disciplines

Medical Sciences | Medicine and Health Sciences | Palliative Care

PubMedID

24225013

Peer Reviewed for front end display

Peer-Reviewed

Department(s)

Department of Medicine, Section of Palliative Medicine and Hospice

Document Type

Article