Early Palliative Care Reduces End-of-Life Health Care Costs

According to a recent study, receipt of early palliative care among patients with cancer reduced the average health system costs in the last month of life compared to those who do not receive early palliative care (JCO Oncol Pract. 2021; OP2100299. doi:10.1200/OP.21.00299).

“This study aimed to investigate the impact of early versus not-early palliative care among cancer decedents on end-of-life health care costs,” wrote Hsien Seow, PhD, Department of Oncology, McMaster University, Hamilton, ON, Canada.

A retrospective cohort of cancer decedents was created between 2004 and 2014, using linked administrative databases in Ontario, Canada. Patients who received palliative care service used in the hospital or community 12 to 6 months before death (defined as “early palliative care”) were selected for this study.

Propensity score matching determined the control group of not-early palliative care, matched on age, sex, cancer type, and stage at diagnosis. Average health system costs like hospital, emergency department, physician, and home care costs in the last month of life were compared between groups.

Of the 144,306 cancer decedents identified in the database, 37% received early palliative care. After matching, 36,238 pairs of decedents were created who received early and not-early (control) palliative care. Age, sex, cancer type (24% lung cancer), and stage (25% stage III and IV) were similar in both groups.

In the early group, 56.3% used inpatient care in the last month (P <.001), costing an average of $7105. In the control group, 66.7% used inpatient care in the last month (P <.001), costing an average of $9370. Overall costs in the last month of life for patients in the early group vs the control group were $12,753 and $14,147, respectively.

“Receiving early palliative care reduced average health system costs in the last month of life, especially via avoided hospitalizations,” Dr Seow and colleagues concluded.—Marta Rybczynski