Preoperative Palliative Care Needs Lead to Higher Post-Surgery Healthcare Utilization in Older Adults with Serious Illness

A recent study published in the Journal of the American College of Surgeons highlights that older adults with serious pre-existing illnesses tend to consume significantly more healthcare resources after undergoing elective surgery. The research analyzed data from 2,499 patients aged 66 and older, spanning from 2007 to 2019, and found that those with identified palliative care needs before surgery had hospital stays twice as long, were twice as likely to return for emergency or hospital care, and incurred nearly double the yearly healthcare costs compared to their healthier counterparts.

The study emphasized that a substantial 79% of these patients exhibited at least one of four clinical characteristics indicating a need for palliative care: moderate to severe pain, depression, functional dependence, and the necessity for a care partner. Over 63% of the population studied were classified as seriously ill. Notably, depression was identified as the most influential factor linked to increased healthcare utilization and costs. Patients with serious illnesses also faced more extended hospital stays and higher total healthcare expenses—averaging $38,187 annually—versus $20,129 for those without serious conditions.

Researchers define serious illness as any life-limiting condition impacting quality of life or heavily burdening caregivers. Palliative care in this context aims to enhance life quality by managing pain, psychological symptoms, and functional needs, while also supporting care partners. As Dr. Jolene Wong Si Min explained, targeted interventions, especially addressing depression, could potentially reduce unnecessary healthcare use.

The authors suggest integrating palliative care approaches into the surgical care pathway, proposing that training surgeons to recognize and address palliative needs may be more feasible than embedding specialists within surgical teams. Future efforts should focus on how to implement generalist palliative care models effectively for seriously ill surgical patients.

This study underscores the importance of preoperative assessment for palliative care needs, emphasizing that timely interventions could improve patient outcomes and reduce healthcare costs.

Source: https://medicalxpress.com/news/2025-07-older-adults-illness-surgery-health.html