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Outpatient Palliative Care Reduces Hospitalizations, Which Impact Costs, While Improving Quality of Life for Seniors and Family Caregivers - New Study in American Journal of Managed Care

NEW YORK, Dec. 2 /PRNewswire/ -- Care Support of America's model of outpatient palliative care coordination, Advanced Illness Coordinated Care (AICC), has been shown to reduce hospitalizations in the last years of life as well as improve the quality of life for seniors and their family caregivers without increasing mortality. These are the principal findings of a new study published in American Journal of Managed Care (November 2009).

Based on a reduction of hospitalizations, readmissions, and emergency room visits, the Care Support of America proven algorithms of care show potential value for payers and hospitals who want to embrace an evidence-based outpatient palliative care approach.

"It is exciting to see payers and hospitals throughout the country working to get seniors and their families quality care in advanced illness and the end of life," says Dan Tobin, M.D., a nationally recognized leader in end-of-life care and CEO of Care Support of America. "This study demonstrates what many of us have been working towards for decades. The healthcare landscape is difficult to navigate and our model clearly shows that most patients and families are looking to avoid unnecessary hospitalizations at the end of life. Each family can choose the direction they wish once they are informed in an objective manner. It is simply good medicine."

Significantly Fewer Admissions

Care Support of America's outpatient palliative care program is an innovative service of non-directive health counseling and care coordination, enhanced with clinical software and delivered in cooperation with treating physicians. Five hundred thirty-two patients with serious advanced illness (cancer, heart failure, pulmonary disease, and renal disease) and 185 caregivers participated in the trial. The study found that patients who received AICC experienced significantly fewer admissions than patients who received usual care.

Joseph B. Engelhardt Ph.D., Care Support of America VP of Research and Development, is lead author of the study, which was supported by Kaiser Permanente and funded by the Garfield Foundation. Dr. Tobin is a co-author.

Health, Coping, and Caregiving Counseling

Participants received six individualized, strengths-based counseling sessions that included: health-related topics; coping with changing health status including anxiety, interpersonal conflicts, and existential concerns; and family caregiving concerns such as maximizing healthcare benefits, home safety, home care, and long term care planning.

Researchers were supported with Web tools and clinical software to ensure that all topics were covered and tasks completed.

Patients who received CSA's Advanced Illness Coordinated Care program were found to have:

  • improved communication and care concerning their symptoms,
  • improved support in understanding and coping with their illness,
  • improved help in accessing spiritual support,
  • improved quality of life.

Both patients and caregivers reported a deeper appreciation of the entire advanced illness health situation, particularly that care coordination and planning for worsening of the illness would be ongoing. Patients were more likely to formulate advance directives. Caregivers in the AICC group reported more attention for their own emotional and spiritual needs.

Bridging Medical and Non-Medical Care

"Our current care delivery system does not routinely include care coordination and practical, emotional, as well as spiritual support to bridge medical and non-medical home care," says Dr. Tobin. "This is critical at the time of a hospital discharge. In the case of advancing cancer, heart, lung, kidney, or Alzheimer's disease, it is important to recognize that these are times when patients and their families need guidance about health-related benefits and hospice."

Currently, only some Medicare health plans and hospitals cover care coordination for outpatient palliative care, and families seeking a family care manager help must pay for the service themselves. As an independent family care manager service, Care Support of America is working with innovative payers and hospitals as well as directly with the consumer.

About Dr. Dan Tobin

Dan Tobin, M.D. is Founder and CEO of Care Support of America, a national family care manager service. He is an adjunct assistant professor of psychiatry (health psychology) at Dartmouth Medical School and the author of books and articles on advanced illness health counseling, family caregiving, and end-of-life care. Dr. Tobin's blog, The Caregiver, appears on the Psychology Today Website at

About Care Support of America

Care Support of America ( is an independent family care manager service that helps patients and families identify and solve advanced illness, family caregiving, and palliative as well as end-of-life care issues.

If you would like to speak with Dr. Tobin or receive a copy of the American Journal of Managed Care study, please contact Davia Temin, Christine Summerson, or Trang Mar of Temin and Company at 212-588-8788 or

Available Topic Expert(s): For information on the listed expert(s), click appropriate link.

Dan Tobin, MD

SOURCE Care Support of America

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