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In-home palliative care increased patient satisfaction and reduced use and costs of medical services

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S Enguidanos

Dr S Enguidanos, Partners in Care Foundation, San Fernando, CA, USA; senguidanos@picf.org

STUDY DESIGN

Design:

randomised controlled trial.

Allocation:

concealed.*

Blinding:

blinded (data collectors).*

STUDY QUESTION

Setting:

2 HMOs in Hawaii and Colorado, USA.

Patients:

310 patients (mean age 74 y, 51% men) who had a primary diagnosis of congestive heart failure, chronic obstructive pulmonary disease, or cancer; had a life expectancy ⩽ 12 months; had visited the emergency department or hospital within the previous year; and scored ⩽ 70% on the Palliative Performance Scale.

Intervention:

in-home palliative care (IHPC) plus usual care (n = 155) or usual care alone (n = 155). IHPC was provided by an interdisciplinary team including the patient and family; a physician, nurse, and social worker with expertise in symptom management and biopsychosocial intervention; and other team members as needed (eg, spiritual counsellor, pharmacist, dietician). …

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