A Comparative Cost-Minimization Analysis of Providing Paediatric Palliative Respite Care before and after the Opening of Services at a Paediatric Hospice

Abstract

A palliative care service provider may add or decrease overall operational costs to the healthcare system. This study assessed the costs of managing respite care for children with life-limiting illness at the Children's Hospital of Eastern Ontario for the 12-month period both before and after services at Roger's House (RH, a paediatric hospice) was made available. The opening and operation of RH for providing respite care resulted in a minimization of operational costs (n = 66 patients, mean decrease of $4,251.95 per month per patient).

Effect of pediatric palliative care programs on health care resource utilization and costs among children with life-threatening conditions: a systematic review of comparative studies

“…We excluded a further 3656 after screening the titles and abstracts, and retrieved 109 papers for full-text review (κ value = 0.25, 95% confidence interval [CI] 0.22-0.28, indicating fair agreement according to Fleiss 9 ). Nine articles fulfilled the inclusion criteria (Figure 1), 5,[10][11][12][13][14][15][16][17] (κ = 0.83, 95% CI 0.64-1.00, indicating almost perfect agreement). Two additional studies 18,19 were identified in the weekly automated search updates, for a total of 11 included studies.…”

“…Four before-after studies used administrative data 5,18 and chart reviews 10,13 to explore differences in outcomes before and after access to a PPCP. Three of the studies compared outcomes in the same group of patients before and after program enrolment and included children with life-threatening conditions.…”

“…Three of the studies compared outcomes in the same group of patients before and after program enrolment and included children with life-threatening conditions. 5,13,18 The other study compared historical cohorts of children with brain tumours before and after implementation of a standardized program for end-of-life care. 10 Observation periods varied, from 12 months to 10 years.…”

“…10 Observation periods varied, from 12 months to 10 years. Determining the point at which children entered the program was based on hospice use, 13 explicit enrolment in the program 5,18 or the date of program implementation. 10 Three studies were based in the US 5,10,18 and one in Canada.…”

“…10 Three studies were based in the US 5,10,18 and one in Canada. 13 One article was classified as a case-control study by the authors, but it was actually a cohort comparison. 17 This US study relied on administrative data to compare children enrolled in a PPCP with those who were not, 6 months before death.…”