Which Cost Components Influence the Cost of Palliative Care in the Last Hospitalization? A Retrospective Analysis of Palliative Care vs. Usual Care at a Swiss University Hospital.

Hagemann, Monika; Zambrano Ramos, Sofia Carolina; Bütikofer, Lukas; Bergmann, Antje; Voigt, Karen; Eychmüller, Steffen (2020). Which Cost Components Influence the Cost of Palliative Care in the Last Hospitalization? A Retrospective Analysis of Palliative Care vs. Usual Care at a Swiss University Hospital. Journal of pain and symptom management, 59(1), 20-29.e9. Elsevier 10.1016/j.jpainsymman.2019.08.026

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CONTEXT Although the number of studies on the economic impact of palliative care (PC) is growing, the great majority report costs from North America. OBJECTIVES We aimed to provide a comprehensive overview of PC hospital cost components from the perspective of a European mixed funded health care system by identifying cost drivers of PC and quantifying their effect on hospital costs compared to usual care (UC). METHODS We performed a retrospective, observational analysis examining cost data from the last hospitalization of patients who died at a large academic hospital in Switzerland comparing patients receiving PC versus UC. RESULTS Total hospital costs were similar in PC and UC with a mean difference of CHF -2'777 [95% confidence interval (CI) -12'713 to 8'506, p=0.60]. Average costs per day decreased by CHF -3'224 [95% CI -3'811 to -2'631, p<0.001] for PC patients with significant reduction of costs for diagnostic intervention and medication. Higher cost components for PC patients were catering, room, nursing, social counselling and non-medical therapists. In sensitivity analyses, when we restricted PC exposure to 3 days from admission, total costs and average costs per day were significantly lower for PC. CONCLUSION Studies measuring the impact of PC on hospital costs should analyze various cost components beyond total costs in order to understand wanted and potentially unwanted cost-reducing effects. An international definition of a set of cost components, specific for cost-impact PC studies, may help avoid superficial and potentially dangerous cost discussions.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Zambrano Ramos, Sofia Carolina; Bütikofer, Lukas and Eychmüller, Steffen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0885-3924

Publisher:

Elsevier

Language:

English

Submitter:

Beatrice Minder Wyssmann

Date Deposited:

18 Sep 2019 15:33

Last Modified:

23 Jan 2020 05:14

Publisher DOI:

10.1016/j.jpainsymman.2019.08.026

PubMed ID:

31518631

Uncontrolled Keywords:

Palliative care cost components financial impact hospitals

BORIS DOI:

10.7892/boris.133339

URI:

https://boris.unibe.ch/id/eprint/133339

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