Hospital utilization of laboratory tests, procedures, and special therapies

Abstract

One area ofhospice which would reflect both cost containment and integrity of palliative philosophy would be the volume of lab tests, procedures, and special therapies utilized. One major study found that in most areas, including utilization, there were no differences between hospice and non-hospice, and yet there is much in the literature about hospice savings due to diagnostic tests and life saving proceduresnot being done. The purpose of this study was to compare the utilization patterns betweenhospiceand non-hospice subjects in the same setting. It wasa retrospective study utilizing the medical records of hospice (n= 53) and non-hospice (n= 50) terminalcancer patients over a one year period. Though not randomized, it was found the two groups were closely matched by age, care days, number of subjects, and diagnosis. The hospice group had significantly less utilization (p .001) in all of the three categories being evaluated. The mean number of diagnostic tests for hospice patients was .94 and forthe non-hospice, 34.98. All ofthe non-hospice patients had at least one test performed while 75.5 percent of the hospice patients had no tests. Further studies are needed to define cost effectiveness, and others to compare level of utilization to quality of life.