Costs of formal and informal care in the last year of life for patients in receipt of specialist palliative care

Abstract

Costs in the last year of life for patients in receipt of specialist palliative care are considerable. Where inpatient hospice care is available, there are potential savings in hospital costs to offset specialist palliative care inpatient costs. Informal care accounts for a high proportion of costs during the last year of life in each area, underlining the important role of informal caregivers in palliative care.

End-of-life experience for older adults in Ireland: results from the Irish longitudinal study on ageing (TILDA)

“…They use routine administrative data on macrolevel supply, but do not capture the needs and experiences of families, or determinants of outcomes [8,9]. They also do not measure unpaid family supports near end of life, which may be of a similar magnitude to formal utilisation [10][11][12][13]. Rankings must be interpreted carefully as high capacity relative to other health care systems does not necessarily correspond to adequate and equitable supply within that country.…”

What is the cost of palliative care in the UK? A systematic review

“…International research has produced similar findings, for example, Chai et al report that 76.7% of the full economic cost of palliative care in Canada is borne by patients’ caregivers in the form of unpaid care 8. More recently, Brick et al  reported that informal care costs account for more than 22% of costs during the last year of life in Ireland 31. Informal care costs are rarely included in economic evaluations in palliative care13 so it is perhaps unsurprising that these costs are largely absent from the studies in this review.…”

The indirect costs of palliative care in end-stage cancer: A real-life longitudinal register- and questionnaire-based study

“…In Georghiou et al's 23 study, informal care costs were not included. 10 According to our previous findings, 24,25 the proportion of informal care increases as the disease progresses from local to metastatic cancer and to palliative state. In this study, the mean weekly duration of informal care received was 11 h as compared to 15 h in Round et al's study.…”

“…In our study, the total cost of the palliative care period per patient (€21,966) was relatively higher than previously reported. In a recent systematic review by Round et al, 16 in which the cost of care was estimated for people with cancer at the end of life in England and Wales, the total costs of end-of-life care were €11,202 and in The Nuffield Trust research report by Georghiou et al, 23 10 HCC covered three-quarters of the total costs. Productivity costs were not estimated.…”