Improving value in cancer care: The case for palliative medicine


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R Sean Morrison1
1Hertzberg Palliative Care Institute, National Palliative Care Research Center, and Mount Sinai Medical Center, New York, USA

Abstract

Modern palliative care, originally conceptualised in the 1960s as care for those with cancer at the end of life, has moved beyond this narrow scope to address the needs of all patients living with serious illness and their families from the time of diagnosis. Modern palliative care is focused on improving quality of life and providing an added layer of support to patients and families in the setting of a serious illness. It is provided at the same time as all other appropriate disease directed and curative treatments.

This plenary session will address three key objectives. First, I will review the needs of an aging society and the imperative for change in how health care is delivered. Second, I will discuss the evidence that demonstrates how modern palliative care improves value (defined as the ration of healthcare quality to cost) in healthcare. Specifically I will review the evidence examining the effect of palliative care on patients' quality of life, patient and family satisfaction, and healthcare expenditures. This discussion will include data from a recently completed multisite study of the effect of palliative care on cancer care in the United States. Finally, this plenary discussion will describe new models of palliative care delivery in within hospitals and community settings and review barriers and opportunities to further integration of palliative care within routine cancer care both within the USA and the UK.