The Triad That Matters: Palliative Medicine, Code Status, and Health Care Costs

Introduction: Delayed discussion of a patient's code status can lead to shortsighted care plans that increase hospital length of stay (LOS) and costs. Methods: Retrospective study compared intensive care unit (ICU) patients who accepted verses rejected palliation and examined the relationships between 5 predictor variables with the outcome variables ICU LOS and total hospital LOS, and total direct and variable hospital cost. Results: A significant number of patients who accepted palliative care agreed to a hospice referral or expired in the hospital. The relationships between days until a family conference, do-not-resuscitate (DNR) order, and the number of invasive procedures were significant. Conclusions: The amount of time that expires until the issue of code status was settled to clearly related to utilization of hospital resources.