Palliative Care Consults in the Southeast: Lower Readmissions Despite Increased Length of Stay.

Abstract

Background: Inpatient palliative care (PC) consultations are increasingly used to address operational challenges. We aimed to understand how PC consultations in a southeastern program, affected by pandemic-related care delays, impacted common clinical performance metrics. Methods: This is a retrospective analysis of a tertiary system's adult patients who received PC consultations from December 2021 to August 2022. A Medicare Severity Diagnosis Related Groups (MS-DRG) code was identified for each PC encounter, and a comparison cohort was created from non-PC encounters. Outcomes: There were 1906 patients who received a PC consultation and 7730 patients in the matched cohort. Patients receiving a PC consultation were older (mean age 68.55 years) compared with the matched cohort (mean age 62.75 years). Despite a significantly longer length of stay (LOS) (12.46 days vs. 6.99 days, p < 0.001), the PC group experienced a lower readmission rate (adjusted odds ratio 0.54, 95% confidence interval 0.44-0.65, p < 0.001). Conclusions: Our cohort study using MS-DRG matching indicates that despite increased LOS, PC consultations were associated with significantly lower readmission rates. This suggests their potential to improve resource utilization, especially in regions affected by pandemic-deferred care.