Palliative care for stroke patients: Meeting the Quadruple Aim.

Authors

Kennedy M. Boone-Sautter, Corewell Health West
M Andrea Peterson
Kristyn Vermeesch, Corewell Health West
Aiesha Ahmed, Corewell Health West

Document Type

Article

Publication Date

5-2025

Publication Title

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

Abstract

BACKGROUND: Stroke patients present health care systems with complex clinical and care needs with high costs of care. Prior to 2022, Corewell Health lacked the palliative care infrastructure to reach and serve the diverse needs of this patient population. Corewell Health-West (CH-W) sought to improve end-of-life care for individuals with serious illness.

OBJECTIVES: To evaluate the extent to which changes in palliative care practices led to improvements in patient outcomes and cost of care.

METHODS: We conducted a retrospective review of palliative care referrals after hospitalization with primary diagnosis of stroke in the CH-W system from 2021 to 2023. Descriptive analysis was utilized to assess the impact and outcomes for patients pre- and post- system improvements.

RESULTS: The emergency department piloted consults directly to palliative which increased from six to seventy-four over a month's time. Stroke patients preferred in-home treatments such as Home Hospice. Fewer patients enrolled in inpatient treatment, such as skilled nursing facilities and inpatient rehab facilities, whose enrollment dropped from 25 % to 11.3 % and 18.3 % to 9.7 % respectively, from 2021 to 2023. Stroke patients enrolled in palliative care experienced lower utilization and costs.

CONCLUSIONS: After expanding resources and standardizing the referral and criteria process to palliative care, an increase in palliative care utilization was observed. This effort expanded care dispositions for palliative care services, allowing individuals more opportunities to receive palliative care treatment at home rather than inpatient.

Volume

34

Issue

5

First Page

108263

Recommended Citation

Boone-Sautter KM, Peterson MA, Vermeesch K, Ahmed A. Palliative care for stroke patients: meeting the quadruple aim. J Stroke Cerebrovasc Dis. 2025 May;34(5):108263. doi: 10.1016/j.jstrokecerebrovasdis.2025.108263. PMID: 39984147.

DOI

10.1016/j.jstrokecerebrovasdis.2025.108263

ISSN

1532-8511

PubMed ID

39984147