• Sean O'Mahony, Tricia J Johnson, Shawn Amer, Marlene E McHugh, Janet McHenry, Laura Fosler, and Vladimir Kvetan.
• 1 Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
• Am J Hosp Palliat Care. 2017 May 1; 34 (4): 330-334.

BackgroundReferrals to palliative care for patients at the end of life in the intensive care unit (ICU) often happen late in the ICU stay, if at all. The integration of a palliative medicine advanced practice nurse (APN) is one potential strategy for proactively identifying patients who could benefit from this service.ObjectiveTo evaluate the association between the integration of palliative medicine APNs into the routine operations of ICUs and hospital costs at 2 different institutions, Montefiore Medical Center (MMC) and Rush University Medical Center.MethodsThe association between collaborative palliative care consultation service programs and hospital costs per patient was evaluated for the 2 institutions. Hospital costs were compared for patients with and without a referral to palliative care using Mann-Whitney U tests.ResultsHospital nonroom and board costs at the Weiler campus of MMC were significantly lower for patients with palliative care compared with those who did not receive palliative care (Median = US$6643 vs US$12 399, P < .001). Cost differences for ICU patients with and without palliative care at Rush University Medical Center were not significantly different.ConclusionOur evaluation suggests that the integration of APNs into a palliative care team for case finding may be a promising strategy, but more work is needed to determine whether reductions in cost are significant.

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