Leaders of public hospital inpatient palliative care (IPPC) services often need to quantify the economic impact of their programs when making the case to health system clinical and administrative leaders to secure resources needed to sustain, improve, or expand the palliative care service.

The materials provided here describe how IPPC impacts hospital costs and offer guidance on how to conduct analyses that quantify economic outcomes. The audiences for these materials are palliative care program leaders and the health system analysts who will be conducting analyses.

• Fiscal Impact of Inpatient Palliative Care: Rationale and Prerequisites (PDF) describes why inpatient palliative care generates positive financial outcomes for hospitals and introduces the prerequisites for assessing impact.
• Fiscal Analyses for Inpatient Palliative Care Programs in Public Hospitals (PDF) describes preparatory tasks that should be undertaken before initiating any analyses, and provides detailed instructions for conducting three core analyses of fiscal impact: (1) an analysis of PC consults that occur within the first three days of hospital stay, (2) an analysis of PC consults that occur later in the hospital stay, and (3) a validating analysis of costs of caring for patients who die in the hospital, comparing those who did and did not receive IPPC services. Discussion of how to account for posthospitalization effects of an inpatient PC consultation is also included.
• Evaluating Baseline Opportunities, Program Reach, and Further Opportunities (PDF) includes instructions for conducting a retrospective analysis that describes the number of hospitalized patients likely to have PC-related needs (uncontrolled symptoms, a need to clarify goals of care, etc.) and the baseline length of stay and costs for hospitalizations where PC was likely needed. For health systems without an IPPC program, this analysis can help with estimating or projecting cost savings based on reaching certain numbers of patients. For health systems with an IPPC program, this analysis can measure its reach and remaining opportunities.
• References for Evaluating the Financial Impact of Inpatient Palliative Care (PDF) is a list of selected peer-reviewed studies that describe economic outcomes for IPPC. The list includes notes on the methods and setting for each study, as well as key findings.