Heart failure (HF) is a prevalent condition associated with poor quality-of-life and high symptom burden. As patients reach ceilings of survival-extending interventions, their priorities may be more readily addressed through the support of palliative care services; however, the best model of care remains unestablished.We aimed to create and evaluate a cospeciality cross-boundary service model for patients with HF that better provides for their palliative care needs in the latter stages of life, while delivering a more cost-effective patient journey.In 2016, the Heart Failure Supportive Care Service (HFSCS) was established to provide patient-centred holistic support to patients with advanced HF. Patient experience questionnaires were developed and distributed in mid-2018 and end-of-2020. Indexed hospital admission data (in-patient bed days pre-referral/post-referral) were used allowing statistical comparisons by paired t-tests.From 2016-2020, 236 patients were referred to the HFSCS. Overall, 75/118 questionnaires were returned. Patients felt that the HFSCS delivered compassionate care (84%) that improved symptoms and quality of life (80% and 65%). Introduction of the HFSCS resulted in a reduction in HF-related admissions: actual days 18.3 to 4 days (p<0.001), indexed days 0.05 to 0.032 days (p=0.03). Cost mapping revealed an estimated average saving of at least £10 218.36 per referral and a total estimated cost saving of approximately £2.4 million over 5 years.This service demonstrates that a cospeciality cross-boundary method of care delivery successfully provides the benefits of palliative care to patients with HF in a value-based manner, while meeting the priorities of care that matter to patients most.

Clea Atkinson

Sian Hughes

Len Richards

Victor MF Sim

Julie Phillips

Imogen J John

Zaheer Yousef

BMJ Supportive & Palliative Care

BMJ SUPPORTIVE & PALLIATIVE CARE 每季度出版一次，并持续在线发布，旨在通过提供高质量、临床相关的研究、评论、评论、信息和具有国际重要性的新闻来连接世界各地的许多学科和专业。我们持有包容性的支持观点和姑息治疗研究，我们能够征集专业知识来批评该主题内的所有方法，包括那些从事过渡研究、临床试验、流行病学、行为科学、伦理和卫生服务研究的方法。与临床实践和临床服务发展相关的文章将被考虑发表。在国际背景下，许多不同类别的临床医生和医疗保健工作者从事与姑息医学、专科或全科姑息治疗、支持性护理、心理社会肿瘤学和临终关怀。我们希望参与许多专业，而不仅仅是那些传统上与支持性和姑息治疗相关的专业。我们希望将读者范围扩大到医生、护士、其他医护人员和医学和外科专业的研究人员，包括但不限于心脏病学、胃肠病学、老年病学、神经病学、肿瘤学、儿科、初级保健、精神病学、心理学、肾脏医学、呼吸药物。

BMJ Supportive and Palliative Care is a quarterly journal that is continuously published online. The journal aims to connect readers from various disciplines and professions by providing high-quality, clinically relevant research, reviews, information, and internationally significant news. We advocate for inclusive perspectives in palliative care research and welcome critiques of diverse approaches within this field, including transitional research, clinical trials, epidemiology, behavioral science, ethics, and health services research. Articles related to clinical practice and service development will be considered for publication. A wide range of clinicians and healthcare professionals engage in palliative medicine, specialty or general palliative care, supportive care, psychosocial oncology, and end-of-life care in an international context. We aim to involve many professionals, not just those traditionally associated with supportive and palliative care. Our goal is to broaden our readership to include physicians, nurses, other healthcare providers, and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, pediatrics, primary care, psychiatry, psychology, nephrology, and respiratory medicine.

BMJ Supportive and Palliative Care 是一本每季度出版的期刊，同时持续在线发布。该期刊旨在通过提供高质量、临床相关的研究、评论、信息和具有国际重要性的新闻，连接来自不同学科和专业的读者。我们支持包容性的姑息治疗研究，欢迎各类专业人士对该领域的不同方法进行批评和探讨，包括过渡研究、临床试验、流行病学、行为科学、伦理学和卫生服务研究等。与临床实践和服务发展相关的文章将被考虑发表。许多不同类别的临床医生和医疗工作者在国际背景下从事姑息医学、专科或全科姑息治疗、支持性护理、心理社会肿瘤学和临终关怀等领域的工作。我们希望吸引更多专业人士的参与，而不仅限于传统的支持性和姑息治疗相关专业。我们的目标是扩大读者群体，包括医生、护士、其他医护人员以及医学和外科专业的研究人员，涵盖心脏病学、胃肠病学、老年病学、神经病学、肿瘤学、儿科、初级保健、精神病学、心理学、肾脏医学和呼吸药物等领域。

BMJ Supportive and Palliative Care

Palliation of heart failure: value-based supportive care

This service demonstrates that a cospeciality cross-boundary method of care delivery successfully provides the benefits of palliative care to patients with HF in a value-based manner, while meeting the priorities of care that matter to patients most.

Category	Quartile
医学	4
医学, 卫生保健与服务	4

Palliation of heart failure: value-based supportive care

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Journal Info

Category	Quartile
HEALTH CARE SCIENCES & SERVICES	3