Recent research has found that palliative care’s value proposition may be gaining momentum across the health continuum and in educational settings.

Palliative Care Paves Way for Stronger Comorbidity Risk Assessment

Patients with liver cancer could benefit from receiving palliative care services and procedures further upstream in their illness trajectories.

Receiving palliative care could help avoid the risk of death in a hospital setting for patients with hepatocellular carcinoma (HCC), a type of liver cancer, according to a study published in Scientific Reports. Researchers examined 345 hospitalized HCC patients who underwent palliative locoregional therapy between January 2015 and December 2022.

Providing liver cancer patients with palliative support led to a higher predictive accuracy of their overall comorbidity risks, the study found.

“Patients with HCC who cannot undergo surgical resection often present with varying degrees of comorbidity burdens,” researchers stated. “The increasing complexity of comorbidities with age underscores the need for a deeper understanding of how age-related factors contribute to the comorbidity burden in HCC patients.”

A large aim of the research was to develop a predictive care model that would better assess the impacts of comorbidities on hospital-related death rates.

Liver cancer patients face higher risks of having multiple comorbidities. Nearly half, or 46.4% of the 345 patients examined had a hepatitis infection, the study found. A large portion of patients also presented with chronic obstructive pulmonary disease, anemia, cirrhosis and hypertension, among other conditions.

Nearly half, or 46.1% of the patients were seniors 65 and older, suggesting a correlation between advanced age and increased comorbidities incidence, researchers indicated the study.

Study Finds Promise in Palliative Care Clinical Education

Providing medical students with greater exposure to palliative care training could help improve health disparities among patients with advanced cancer and blood conditions.

This is according to research published in the American Society of Clinical Oncology’s (ASCO) Journal of Clinical Oncology. The research spanned a pilot study of 19 hematology-oncologist (HO) medical students who received clinical rotations in integrated palliative care (PC) between 2018 – 2023 at the Pennsylvania-based Fox Chase Cancer Center.

Medical fellows reported an improved understanding of palliative care and feeling more prepared to provide these services, the study found. Majority of the students (94%) rated the palliative clinical rotation as valuable or extremely valuable. All students reported that the exposure changed their clinical practice and helped them be more engaged when caring for seriously ill patients.

“Our pilot study of a novel, longitudinal, integrated PC continuity rotation for HO fellows was highly feasible and acceptable,” the researchers stated. “The rotation changed clinical practice and improved fellows’ PC knowledge and skill confidence. This could serve as a model for integrating PC education into HO fellowships nationally.”

Paramedic Palliative Care Generates Strong ROI

Paramedics providing community-based palliative care services to patients in the home have helped reduce hospitalization and emergency costs across three provinces in Canada. Researchers analyzed the outcomes of more than 5,400 emergency calls placed from April 1, 2020 to March 31, 2022.

More than 60% of individuals with palliative care needs supported by paramedics avoided transport to an emergency department setting, according to the analysis published in the Canadian Journal of Emergency Medicine. Those who received palliative support reported higher quality of life and were associated with a cost savings of about $2,773 Canadian dollars for each emergency call.

“In a context of crowded emergency departments and considering patient preferences to receive palliative care and die at home, the results of this economic evaluation support the continued implementation and spread of paramedic-based palliative care at home in Canada, as the program was found to be cost-effective across the majority of scenarios simulated,” the researchers stated in the analysis.

The paramedic palliative program was launched across five geographic regions but points to the potential for a more cost-effective care model with improved outcomes, according to the researchers. The findings suggest that roughly one-third of all 9-1-1 calls could be treated in the home with palliative paramedic support versus in the hospital.

The program resulted in a return on investment of nearly $4.60 for every dollar invested, according to the findings.

The findings build on a trend in taking shape in the United States. Hospices and hospital emergency department collaborations have helped to shrink health care costs, generate revenue and improve outcomes. These metrics are key to stakeholders, particularly within the value-based environment, where several palliative care reimbursement inroads lay.