Changing the Care Paradigm for Patients: Advanced Illness Beds Care Model

• Published in: American journal of hospice & palliative medicine 2021-11, Vol.38 (11), p.1336-1341
• Main Authors: Rimar, Alexander, Friedman, M. Isabel, Quinteros, Maria G., Gooch, Rebecca A., Masick, Kevin D., DaCosta, Nicholas, Spooner, Rachael L.
• Format: Article
• Language: English
• Subjects: Aged; Critical Care; Delivery of Health Care; Hospitals; Humans; Intensive Care Units; Retrospective Studies; United States
• ISSN: 1049-9091; 1938-2715
• DOI: 10.1177/1049909120984384

Background: Over 90 million Americans suffer from advanced illness (AI) and spend their last days of life in critical care units receiving costly, unwanted, aggressive medical care. Objective: Evaluate the impact of a specialized care model in medical/surgical units for hospitalized geriatric patients and patients with complex care requirements where designated AI beds align care with patient’s wishes/goals, minimize aggressive interventions, and influence efficient resource utilization. Design: US based multi-facility retrospective, longitudinal descriptive study of screened positive AI patients in AI Beds (N = 1,237) from 3 facilities from 2015 to 2017. Results: Patient outcomes included 60% referrals to AI beds from ICU, a decrease of 39-49% in average ICU LOS, a 23% reduction of AI bed patient expirations, 9.0% referrals to hospice, and projected cost savings of $4,361.66/patient, US dollars. Conclusion: Allocating AI beds to deliver care to AI patients resulted in a decreased cost of care by reducing overall hospital LOS, mortality, and efficient use of both critical care and hospital resources.