Integration of Oncology and Palliative Care in a Solid Tumor Inpatient Service

Key Points

  • The postintervention group had a lower rate of 7-day readmission.
  • Trends toward improvement were observed in the mean length of stay and hospice referral.

In a retrospective study reported in the Journal of Oncology Practice, Riedel et al found that integration of oncology and palliative care in a solid tumor inpatient service resulted in improvements in quality-of-care metrics during the first year of implementation.

Study Details

The study compared health system and patient outcomes in a preintervention cohort of 731 patients (1,170 encounters) admitted to the solid tumor inpatient service at Duke University Hospital between September 2009 and June 2010 with those in a postintervention cohort of 783 patients (1,183 encounters) admitted between September 2011 and June 2012. Baseline characteristics were similar in the two groups.

Outcomes

Patients in the postintervention cohort had a significantly lower 7-day readmission rate (adjusted odds ratio = 0.76, P = .0482). The postintervention group showed trends toward a decreased mean length of stay (4.2 vs 4.5 days, P = .0651), increased hospice referral (14.3% vs 11.9%, P = .0837), and decreased intensive care unit transfers (1.6% vs 1.9%, P = .61). No significant differences between the groups were observed for 30-day readmission or 7- or 30-day emergency department return, although a trend toward a lower 7-day emergency department return was observed in the postintervention cohort (adjusted OR = 0.84, P = .2909). Surveys of participating nurses and rounding oncologists indicated that both groups favored the integrated model.

The investigators concluded: “A fully integrated inpatient partnership between [palliative care] and medical oncology is associated with significant and clinically meaningful improvements in key health system–related outcomes and indicators of quality cancer care.”

Richard F. Riedel, MD, of Duke University Medical Center, is the corresponding author of the Journal of Oncology Practice article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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