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Electronic medical orders for life-sustaining treatment in New York State: Length of stay, direct costs in an ICU setting

Published online by Cambridge University Press:  14 January 2019

Denise Serrano-Eanelli ,
Emma Fattakhov ,
Murali Krishna ,
Jill Embler ,
Steven Byrne ,
Claudia DiBlasi ,
Kaitlyn Ludwigsen ,
Yasmin Leigh  and
Hasanat Alamgir
Denise Serrano-Eanelli*
Affiliation:
New York Medical College, Department of Health Policy and Management, Valhalla, NY
Emma Fattakhov
Affiliation:
Orange Regional Medical Center, Middletown, NY
Murali Krishna
Affiliation:
Orange Regional Medical Center, Middletown, NY
Jill Embler
Affiliation:
Orange Regional Medical Center, Middletown, NY
Steven Byrne
Affiliation:
Orange Regional Medical Center, Middletown, NY
Claudia DiBlasi
Affiliation:
Touro College of Osteopathic Medicine, Middletown, NY
Kaitlyn Ludwigsen
Affiliation:
Touro College of Osteopathic Medicine, Middletown, NY
Yasmin Leigh
Affiliation:
Orange Regional Medical Center, Middletown, NY
Hasanat Alamgir
Affiliation:
New York Medical College, Department of Health Policy and Management, Valhalla, NY
*
Author for correspondence: Denise Serrano-Eanelli, 293 Burlingham Rd, Pine Bush, NY 12566. E-mail: [email protected]
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Abstract

Objective

In the United States, approximately 20% patients die annually during a hospitalization with an intensive care unit (ICU) stay. Each year, critical care costs exceed $82 billion, accounting for 13% of all inpatient hospital costs. Treatment of sepsis is listed as the most expensive condition in US hospitals, costing more than $20 billion annually. Electronic Medical Orders for Life-Sustaining Treatment (eMOLST) is a standardized documentation process used in New York State to convey patients’ wishes regarding cardiopulmonary resuscitation and other life-sustaining treatments. No study to date has looked at the effect of eMOLST as an advance care planning tool on ICU and hospital costs using estimates of direct costs. The objective of our study was to investigate whether signing of eMOLST results in any reduction in length of stay and direct costs for a community-based hospital in New York State.

Method

A retrospective chart review was conducted between July 2016 and July 2017. Primary outcome measures included length of hospital stay, ICU length of stay, total direct costs, and ICU costs. Inclusion criteria were patients ≥65 years of age and admitted into the ICU with a diagnosis of sepsis. An independent samples t test was used to test for significant differences between those who had or had not completed the eMOLST form.

Result

There were no statistical differences for patients who completed or did not complete the eMOLST form on hospital's total direct cost, ICU cost, total length of hospital stay, and total hours spent in the ICU.

Significance of results

Completing an eMOLST form did not have any effect on reducing total direct cost, ICU cost, total length of hospital stay, and total hours spent in the ICU.

Keywords

Direct costeMOLSTICULOSSepsis
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 5 , October 2019 , pp. 584 - 589
Copyright
Copyright © Cambridge University Press 2019 

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