ABSTRACT
Outcomes for SPC may represent a variety of perspectives, including patient, family, other care providers, the hospital, payers, and society. This is not to say that all clinical effects will automatically produce hospital-level financial and operational effects, but it is to say that financial outcomes are dependent upon clinical impact. The first principle of measuring the financial impact of SPC, then, is to measure it as a consequence of patient-centered clinical and psycho-social-spiritual outcomes. Financial outcomes are secondary effects of these, and therefore, in practice, SPC program leaders should measure the patient-centered and social outcomes first, before turning to institutional outcomes such as lower costs or fewer Intensive Care Unit days. Higginson's early reviews covered both SPC and related interventions that included utilization outcomes in studies dating from 1998.
