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OBJECTIVES: To determine whether an inhome palliative care intervention for terminally ill patients can improve patient satisfaction, reduce medical care costs, and increase the proportion of patients dying at home.

DESIGN: A randomized, controlled trial.

SETTING: Two health maintenance organizations in two states.

PARTICIPANTS: Homebound, terminally ill patients (N=298) with a prognosis of approximately 1 year or less to live plus one or more hospital or emergency department visits in the previous 12 months.

INTERVENTION: Usual versus inhome palliative care plus usual care delivered by an interdisciplinary team providing pain and symptom relief, patient and family education and training, and an array of medical and social support services.

MEASUREMENTS: Measured outcomes were satisfaction with care, use of medical services, site of death, and costs of care.

RESULTS: Patients randomized …