Cost Savings Associated With Palliative Care Among Older Adults With Advanced Cancer

Abstract

Background: There is inconsistent evidence that palliative care intervention decreases total healthcare expenditure at end-of-life for oncology patients. This inconsistent evidence may result from small sample sizes at single institution studies and disparate characterization of costs across studies. Comprehensive studies in population-based datasets are needed to fully understand the impact of palliative care on total healthcare costs. This study analyzed the impact of palliative care on total healthcare costs in a nationally representative sample of advanced cancer patients. Methods: We conducted a matched cohort study among Medicare patients with metastatic lung, colorectal, breast and prostate cancers. We matched patients who received a palliative care consultation to similar patients who did not receive a palliative care consultation on factors related to both the receipt of palliative care and end of life costs. We compared direct costs between matched patients to determine the per-patient economic impact of a palliative care consultation. Results: Patients who received a palliative care consultation experienced an average per patient cost of $5,834 compared to $7,784 for usual care patients (25% decrease; p < 0.0001). Palliative care consultation within 7 days of death decreased healthcare costs by $451, while palliative care consultation more than 4 weeks from death decreased costs by $4,643. Conclusion: This study demonstrates that palliative care has the capacity to substantially reduce healthcare expenditure among advanced cancer patients. Earlier palliative care consultation results in greater cost reductions than consultation in the last week of life.

Palliative care and healthcare utilization among deceased metastatic lung cancer patients in U.S. hospitals

“…Health policymakers must learn to promote access to the service which may reduce unnecessary interventions at 'patients' end of life. Other studies also suggested palliative care reduces healthcare cost for seriously ill lung cancer patients [ 15 , 28 – 30 ]. However, the datasets of those studies were limited to certain population groups.…”

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

“…7,21,31 However, they refer to the cancer population, and focus on reducing hospital stays, days in the ICU, or use of chemotherapy. 39,40 This study included both oncological and non-oncological patients, focusing on the last hospital admission of patients dying in the hospital, showing that savings with PC teams were due to the more appropriate use of hospital resources. Similarly, certain studies show economic benefits with better cost efficiency in non-cancer patients seen by PC teams, but they have again focused on overall reduction of admission costs and not on a cost analysis according to the resources used, as performed in this study.…”

Cuidados paliativos en adultos mayores con cáncer de próstata

“…Este estudio demuestra que los cuidados paliativos tienen la capacidad de reducir sustancialmente el gasto sanitario entre los pacientes con cáncer avanzado. La consulta temprana de cuidados paliativos da lugar a mayores reducciones de costes que la consulta en la última semana de vida (Sheridan et al, 2021).…”