End of Life Cost Savings in the Palliative Care Unit Compared to Other Services

Abian, María Herrera; Tejedor, Antonio Luis Noguera; Rodríguez, Cristina Antón

doi:10.1016/j.jpainsymman.2022.06.016

Cited by 6 publications

(5 citation statements)

References 30 publications

(33 reference statements)

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“…It also aligns with another study conducted by Abian et al (18) , in which it was highlighted that patients assisted by palliative care teams during their last hospitalization had lower costs compared to those who did not receive this assistance, even with the same level of severity and risk of mortality. The authors emphasized the importance of integrating knowledge in palliative care into the training programs of medical specialties that deal with advanced and complex diseases.…”

Section: Discussionsupporting

confidence: 88%

“…In addition to all the benefits provided to patients and their families, evidence has shown that palliative care teams effectively reduce the cost of clinical care for patients with advanced diseases without compromising the quality of care provided to them (13,18,19) . Thus, a care model based on palliative care can also be a decisive factor in reducing healthcare resource waste (19)(20)(21)(22)(23) .…”

Section: Introductionmentioning

confidence: 99%

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The suffering is expensive: comparison of therapeutic costs between palliative care and dysthanasia patient

De Freitas Melo,

Vieira da Cunha,

Moreira Costa

et al. 2024

Psicooncología

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Objectives: Several studies highlight benefits of palliative care for patients with lifethreatening illnesses, especially in terms of pain control and improving life quality. However, there is still research gap, particularly in the Brazilian context, regarding its ability to reduce costs associated with unnecessary invasive tests and procedures often invested in dysthanasia patients, thereby relieving the burden on the healthcare system. Given this scenario, the objective was to determine whether there is a significant difference in healthcare costs between cancer patients receiving palliative care and those in dysthanasia. Method: Documentary research, analyzing 94 medical records of patients who died from cancer in a hospital, divided into two groups: 47 in palliative care and 47 in dysthanasia. The groups had their average costs compared by surveying all tests and procedures recorded in the last 30 days of each patient’s life, with values scored based on the price table of the Unified Health System (Sistema Único de Saúde). Results: Patients receiving curative care in dysthanasia incurred an average cost of 2,316.92 Brazilian Reais (SD = 3,146.60) for tests and procedures in the last 30 days of life. Patients in palliative care had an average cost of 945.40 Brazilian Reais (SD = 2,508.01). There is a statistically significant difference in the invested values between patients in palliative care and those in dysthanasia (U = 620.00; Z = -4.334; p < 0.001). Conclusions: Implementing palliative care can be considered an effective strategy for reducing hospital costs, leading to significant savings within the healthcare system.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

The suffering is expensive: comparison of therapeutic costs between palliative care and dysthanasia patient

De Freitas Melo,

Vieira da Cunha,

Moreira Costa

et al. 2024

Psicooncología

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“…Given the fact that older patients with cancer even more so prefer dying at home, this is a high number [ 58 ]. Hospital death has also been associated with higher healthcare service use and cost in the EOL period [ 59 , 60 ]. In a large US study of older patients dying of cancer, 36% died in the hospital or hospice and 19% in a nursing home [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

End-of-Life Care in the Last Three Months before Death in Older Patients with Cancer in Belgium: A Large Retrospective Cohort Study Using Data Linkage

Depoorter

Vanschoenbeek²,

Decoster

et al. 2023

Cancers

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This study aims to describe end-of-life (EOL) care in older patients with cancer and investigate the association between geriatric assessment (GA) results and specialized palliative care (SPC) use. Older patients with a new cancer diagnosis (2009–2015) originally included in a previous multicentric study were selected if they died before the end of follow-up (2019). At the time of cancer diagnosis, patients underwent geriatric screening with Geriatric 8 (G8) followed by GA in case of a G8 score ≤14/17. These data were linked to the cancer registry and healthcare reimbursement data for follow-up. EOL care was assessed in the last three months before death, and associations were analyzed using logistic regression. A total of 3546 deceased older patients with cancer with a median age of 79 years at diagnosis were included. Breast, colon, and lung cancer were the most common diagnoses. In the last three months of life, 76.3% were hospitalized, 49.1% had an emergency department visit, and 43.5% received SPC. In total, 55.0% died in the hospital (38.5% in a non-palliative care unit and 16.4% in a palliative care unit). In multivariable analyses, functional and cognitive impairment at cancer diagnosis was associated with less SPC. Further research on optimizing EOL healthcare utilization and broadening access to SPC is needed.

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“…Studies have shown that patients receiving palliative care present improved quality of life and a lower risk of developing depressive symptoms [ 46 , 47 ]; they also use fewer healthcare resources, giving rise to lower overall expenses [ 48 ]. As described in the methodology section, this qualitative study forms part of a cost-benefit study, in which we demonstrated that palliative care was associated with lower rates of iatrogenic events, fewer test orders, and fewer prescriptions, while ensuring optimal clinical and symptomatic control [ 49 ]. Participants interviewed in this study not only perceived excellent overall care from palliative care units, but also appropriateness of treatment with regards to their loved one’s situation.…”

Section: Discussionmentioning

confidence: 99%

The caregiver’s perspective on end-of-life inpatient palliative care: a qualitative study

Herrera-Abián,

Castañeda-Vozmediano,

Antón-Rodríguez

et al. 2023

Annals of Medicine

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Introduction Understanding patient and caregiver experience is key to providing person-centered care. The palliative care approach includes holistic assessment and whole-person care at the end of life, that also involves the patient’s family and loved ones. The aim of this study was to describe the way that family caregivers experienced patients’ deaths during their loved ones’ last hospital admission, comparing inpatient palliative care (PCU) and non-palliative care (Non-PCU) units. Methods A qualitative case study approach was implemented. Family caregivers of terminally ill patients admitted to the Infanta Elena Hospital (Madrid, Spain) between 2016 and 2018 were included using purposeful sampling. Eligible caregivers were first-degree relatives or spouses present during the patient’s last hospital admission. Data were collected via in-depth interviews and researchers’ field notes. Semi-structured interviews with a question guide were used. A thematic inductive analysis was performed. The group of caregivers of patients admitted to the PCU unit and the group of caregivers of patients admitted to Non-PCU were analyzed separately, through a matrix. Results In total 24 caregivers (12 from the PCU and 12 from Non-PCU units) were included. Two main themes were identified: caregivers’ perception of scientific and technical appropriateness of care, and perception of person-centred care. Scientific appropriateness of care was subdivided into two categories: diagnostic tests and treatment, and symptom control. Perception of person-centred care was subdivided as: communication, emotional support, and facilitating the farewell process. Caregivers of patients admitted to a PCU unit described their experience of end-of-life care as positive, while their Non-PCU unit counterparts described largely negative experiences. Conclusions PCU provides a person-centered approach to care at the end of life, optimizing treatment for patients with advanced disease, ensuring effective communication, establishing a satisfactory professional relationship with both patients and their loved ones, and facilitating the farewell process for family caregivers.

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End of Life Cost Savings in the Palliative Care Unit Compared to Other Services

Cited by 6 publications

References 30 publications

The suffering is expensive: comparison of therapeutic costs between palliative care and dysthanasia patient

The suffering is expensive: comparison of therapeutic costs between palliative care and dysthanasia patient

End-of-Life Care in the Last Three Months before Death in Older Patients with Cancer in Belgium: A Large Retrospective Cohort Study Using Data Linkage

The caregiver’s perspective on end-of-life inpatient palliative care: a qualitative study

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