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Effect of Early Palliative Care on End-of-Life Health Care Costs: A Population-Based, Propensity Score–Matched Cohort Study

This study aimed to investigate the impact of early versus not-early palliative care among cancer decedents on end-of-life health care costs. METHODS: Using linked administrative databases, we created a retrospective cohort of cancer decedents between 2004 and 2014 in Ontario, Canada. We identified...

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Autores principales: Seow, Hsien, Barbera, Lisa C., McGrail, Kimberlyn, Burge, Fred, Guthrie, Dawn M., Lawson, Beverley, Chan, Kelvin K. W., Peacock, Stuart J., Sutradhar, Rinku
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8758090/
https://www.ncbi.nlm.nih.gov/pubmed/34388021
http://dx.doi.org/10.1200/OP.21.00299
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author Seow, Hsien
Barbera, Lisa C.
McGrail, Kimberlyn
Burge, Fred
Guthrie, Dawn M.
Lawson, Beverley
Chan, Kelvin K. W.
Peacock, Stuart J.
Sutradhar, Rinku
author_facet Seow, Hsien
Barbera, Lisa C.
McGrail, Kimberlyn
Burge, Fred
Guthrie, Dawn M.
Lawson, Beverley
Chan, Kelvin K. W.
Peacock, Stuart J.
Sutradhar, Rinku
author_sort Seow, Hsien
collection PubMed
description This study aimed to investigate the impact of early versus not-early palliative care among cancer decedents on end-of-life health care costs. METHODS: Using linked administrative databases, we created a retrospective cohort of cancer decedents between 2004 and 2014 in Ontario, Canada. We identified those who received early palliative care (palliative care service used in the hospital or community 12 to 6 months before death [exposure]). We used propensity score matching to identify a control group of not-early palliative care, hard matched on age, sex, cancer type, and stage at diagnosis. We examined differences in average health system costs (including hospital, emergency department, physician, and home care costs) between groups in the last month of life. RESULTS: We identified 144,306 cancer decedents, of which 37% received early palliative care. After matching, we created 36,238 pairs of decedents who received early and not-early (control) palliative care; there were balanced distributions of age, sex, cancer type (24% lung cancer), and stage (25% stage III and IV). Overall, 56.3% of early group versus 66.7% of control group used inpatient care in the last month (P < .001). Considering inpatient hospital costs in the last month of life, the early group used an average (±standard deviation) of $7,105 (±$10,710) versus the control group of $9,370 (±$13,685; P < .001). Overall average costs (±standard deviation) in the last month of life for patients in the early versus control group was $12,753 (±$10,868) versus $14,147 (±$14,288; P < .001). CONCLUSION: Receiving early palliative care reduced average health system costs in the last month of life, especially via avoided hospitalizations.
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spelling pubmed-87580902023-01-01 Effect of Early Palliative Care on End-of-Life Health Care Costs: A Population-Based, Propensity Score–Matched Cohort Study Seow, Hsien Barbera, Lisa C. McGrail, Kimberlyn Burge, Fred Guthrie, Dawn M. Lawson, Beverley Chan, Kelvin K. W. Peacock, Stuart J. Sutradhar, Rinku JCO Oncol Pract ORIGINAL CONTRIBUTIONS This study aimed to investigate the impact of early versus not-early palliative care among cancer decedents on end-of-life health care costs. METHODS: Using linked administrative databases, we created a retrospective cohort of cancer decedents between 2004 and 2014 in Ontario, Canada. We identified those who received early palliative care (palliative care service used in the hospital or community 12 to 6 months before death [exposure]). We used propensity score matching to identify a control group of not-early palliative care, hard matched on age, sex, cancer type, and stage at diagnosis. We examined differences in average health system costs (including hospital, emergency department, physician, and home care costs) between groups in the last month of life. RESULTS: We identified 144,306 cancer decedents, of which 37% received early palliative care. After matching, we created 36,238 pairs of decedents who received early and not-early (control) palliative care; there were balanced distributions of age, sex, cancer type (24% lung cancer), and stage (25% stage III and IV). Overall, 56.3% of early group versus 66.7% of control group used inpatient care in the last month (P < .001). Considering inpatient hospital costs in the last month of life, the early group used an average (±standard deviation) of $7,105 (±$10,710) versus the control group of $9,370 (±$13,685; P < .001). Overall average costs (±standard deviation) in the last month of life for patients in the early versus control group was $12,753 (±$10,868) versus $14,147 (±$14,288; P < .001). CONCLUSION: Receiving early palliative care reduced average health system costs in the last month of life, especially via avoided hospitalizations. Wolters Kluwer Health 2022-01 2021-08-13 /pmc/articles/PMC8758090/ /pubmed/34388021 http://dx.doi.org/10.1200/OP.21.00299 Text en © 2021 by American Society of Clinical Oncology https://creativecommons.org/licenses/by-nc-nd/4.0/Creative Commons Attribution Non-Commercial No Derivatives 4.0 License: https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle ORIGINAL CONTRIBUTIONS
Seow, Hsien
Barbera, Lisa C.
McGrail, Kimberlyn
Burge, Fred
Guthrie, Dawn M.
Lawson, Beverley
Chan, Kelvin K. W.
Peacock, Stuart J.
Sutradhar, Rinku
Effect of Early Palliative Care on End-of-Life Health Care Costs: A Population-Based, Propensity Score–Matched Cohort Study
title Effect of Early Palliative Care on End-of-Life Health Care Costs: A Population-Based, Propensity Score–Matched Cohort Study
title_full Effect of Early Palliative Care on End-of-Life Health Care Costs: A Population-Based, Propensity Score–Matched Cohort Study
title_fullStr Effect of Early Palliative Care on End-of-Life Health Care Costs: A Population-Based, Propensity Score–Matched Cohort Study
title_full_unstemmed Effect of Early Palliative Care on End-of-Life Health Care Costs: A Population-Based, Propensity Score–Matched Cohort Study
title_short Effect of Early Palliative Care on End-of-Life Health Care Costs: A Population-Based, Propensity Score–Matched Cohort Study
title_sort effect of early palliative care on end-of-life health care costs: a population-based, propensity score–matched cohort study
topic ORIGINAL CONTRIBUTIONS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8758090/
https://www.ncbi.nlm.nih.gov/pubmed/34388021
http://dx.doi.org/10.1200/OP.21.00299
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