Organization of the U.S. Healthcare System

Predict the economic impact (e.g., costs, benefits, efficiency, cost containment) on healthcare delivery at the local, state, national, or international level if the legislative bill were enacted.

This paper examines the economic impact upon the nation if the bill, the Palliative Care and Hospice Education and Training Act, were passed. Fundamentally, the economic impact of the bill would ultimately be a positive one. The bill proposes the necessity for better training and support for the clinicians who will ultimately work in palliative care. The bill represents a long-term investment: more expenditure to better train and educate these professional healthcare personnel, but with the understanding that definitive savings will be substantial. First of all, there's almost always a substantial amount of fiscal savings when the quality of care is improved; this has been demonstrated in a range of studies and is something which is experienced at the local and national level. For instance, according to a study which was printed in the Archives of Internal Medicine, it was discovered that when consultation teams were implemented into palliative care the savings were significant (2008). "The study concluded that palliative care patients discharged alive had an adjusted net savings of $1,696 in direct costs per admission and $279 in direct costs per day, and palliative care patients who died in the hospital had an adjusted net savings of $4,908 in direct costs per admission and $374 in direct costs per day. For an average 400-bed hospital containing an interdisciplinary palliative care team seeing 500 patients a year, net savings to the hospital each year would be $1.3 million per year" (ascan.org). While the estimated cost of the Bill would be $50 million over five years, the long-term savings would eventually be worth it in ten to twenty years in the savings reaped.

Furthermore, with enhanced education, nurses and other clinicians can understand the benefits and the connections with advance directives which, if done early in the entire process, can save end of life care costs, but don't end up impacting care choices. When nurses are better educated in how to coordinate palliative care, clinical outcomes can generally improve and reap significant savings for professional healthcare facilities on the local and national level. While more research needs to be done, the bill is a manifestation of the belief that high-volume care can prevent end-of-life hospitalizations, such as via the early implementation of advanced-directives.