Impact of home-based palliative care on health care costs and hospital use: A systematic review.

Gonzalez-Jaramillo, Valentina; Fuhrer, Valérie; Gonzalez-Jaramillo, Nathalia; Kopp-Heim, Doris; Eychmüller, Steffen; Maessen, Maud (2021). Impact of home-based palliative care on health care costs and hospital use: A systematic review. Palliative & Supportive Care, 19(4), pp. 474-487. Cambridge University Press 10.1017/S1478951520001315

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OBJECTIVE

To assess the effectiveness of home-based palliative care (HBPC) on reducing hospital visits and whether HBPC lowered health care cost.

METHOD

We searched six bibliographic databases (Embase (Ovid); Cochrane Central Register of Controlled Trials; Medline (Ovid); PubMed; Web of Science Core Collection; and, CINAHL) until February 2019 and performed a narrative synthesis of our findings.

RESULTS

Of the 1,426 identified references, 21 articles based on 19 unique studies met our inclusion criteria, which involved 92,000 participants. In both oncological and non-oncological patients, HBPC consistently reduced the number of hospital visits and their length, as well as hospitalization costs and overall health care costs. Even though home-treated patients consumed more outpatient resources, a higher saving in the hospital costs counterbalanced this. The reduction in overall health care costs was most noticeable for study periods closer to death, with greater reductions in the last 2 months, last month, and last two weeks of life.

SIGNIFICANCE OF RESULTS

Stakeholders should recognize HBPC as an intervention that decreases patient care costs at end of life and therefore health care providers should assess the preferences of patients nearing the end-of-life to identify those who will benefit most from HBPC.

Item Type:

Journal Article (Review 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 > Institute of Social and Preventive Medicine (ISPM)
13 Central Units > Administrative Director's Office > University Library of Bern

UniBE Contributor:

Gonzalez Jaramillo, Valentina; Gonzalez Jaramillo, Nathalia; Kopp, Doris; Eychmüller, Steffen and Maessen, Maud

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services
000 Computer science, knowledge & systems > 020 Library & information sciences

ISSN:

1478-9523

Publisher:

Cambridge University Press

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

17 Dec 2020 10:56

Last Modified:

01 Aug 2021 01:31

Publisher DOI:

10.1017/S1478951520001315

PubMed ID:

33295269

Uncontrolled Keywords:

Community care Domiciliary care Health care cost Palliative care

BORIS DOI:

10.7892/boris.149808

URI:

https://boris.unibe.ch/id/eprint/149808

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