Limits of outpatient palliative oncological care: A cost analysis of nutritional interventions.

Abstract

Background The purpose of palliative medicine is to achieve and maintain the best possible quality of life for patients and support their families, relatives, and friends. Therefore, we conducted a case-control observational retrospective study evaluating the economic burden of nutritional intervention during ambulatory palliative oncology care, aiming to implement the obtained data to the quality of healthcare. Methods A comparison of total expenses per patient was made between the three groups of patients, i.e., Group A – 256 patients with systematic nutritional intervention during 2020-22, Group B − 1393 patients treated during 2020-22, and Group C – 940 patients without systematic nutritional intervention during in 2017-19. The expense analysis was performed using mixed methods monitoring nutritional intervention, i.e. medical records, laboratory tests, and insurance bills from the palliative oncology clinic. The collected data included four categories (direct and indirect cost): nutritional supplements, other medical expenses, requested care, and other care. The qualitative costs and benefits analyses were done within the CBA method framework, i.e. online interviews of relevant stakeholders who were involved in the process of nutritional measures. Results The Mann–Whitney U-test showed significant (P < 0.001) differences between the tested groups, with the lowest median of total expenses in Group B (2,921 CZK) and the highest in Group A (16,692 CZK), demonstrating a significant reduction in total expenses. The same was observed in the comparison between Group C (4,923 CZK) and Group B (2,921 CZK) during 2020-22. Conclusion The present study proves that nutritional intervention, and the related modifications in palliative treatment, benefit the patients and reduce the overall costs of healthcare.