Collaborative Home-Based Palliative Care Cuts Risk of Hospital Deaths by 48%

Posted September 28, 2022

By: Diana Eastabrook

McKnights Home Care

Patients with chronic heart failure who received collaborative home-based palliative care were more likely to die at home, rather than in a hospital, according to new research.

Investigators studied more than 1,400 patients with chronic heart failure from two large health districts in Ontario, Canada, between 2013 and 2019. The sub-group of patients who received home-based palliative care had a 48% lower risk of dying in the hospital than those who received more standard care.

The study also found that the 245 patients who received home-based palliative care were at lower risk of being admitted to the hospital or visiting an emergency department than the 1,162 patients who received standard care.

The collaborative care model emphasized advance care planning, home-based management of heart failure, standardized protocols for clinical care, education for patients, families and clinicians and collaboration between healthcare professionals.

Implementing the model would not require any major restructuring on the part of medical providers, according to study co-author Kieran Quinn, MD, palliative care physician with Sinai Health and the University of Toronto.

“However, scalability does require increased awareness on the part of all providers of the potential to provide integrated palliative and heart failure care,” Quinn added in a statement.

Palliative care is a model that provides specialized care, including emotional and spiritual support, for those living with serious illnesses. Many private health insurers, as well as approximately 130 Medicare Advantage plans cover palliative care. Medicare Part B will only pay for palliative care provided by physicians, nurse practitioners and clinical social workers.

Momentum is building for the Centers for Medicare and Medicaid Services to provide a more expansive payment model for palliative care. Some  policy experts believe the COVID-19 pandemic is helping to increase awareness for more expansive coverage as an increasing number of people struggle with symptoms of long COVID-19.

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