Reducing healthcare costs through early palliative care in terminal cancer: Evidence from a retrospective cohort study
Keywords:
palliative care, healthcare costs, cancer, early palliative careAbstract
Introduction: Palliative care focuses on improving the quality of life for patients and their families, particularly for those with terminal cancer. Early initiation of palliative care could reduce unnecessary medical services and healthcare costs.
Objective: This study aimed to evaluate the impact of early palliative care on healthcare costs for end-stage cancer patients and compare healthcare utilization between patients receiving early palliative care and those who did not.
Methods: A retrospective cohort study was conducted using medical records of all cancer decedents at Nakornping Hospital between January 2016 and December 2023. Data were analyzed using descriptive statistics, and differences between groups were tested using t-tests, Chi-square tests, Kruskal-Wallis tests, and ANOVA.
Results: A total of 880 patients were included, with 67.95% not receiving palliative care, 28.75% receiving late palliative care, and 3.3% receiving early palliative care. The group receiving early-stage palliative care had the lowest utilization of healthcare services in the last month of life, with a median hospital stay of 5 days (IQR 3-10; p = 0.005) and the lowest inpatient costs at 29,068 Baht (IQR 15,436-60,240; p = 0.030). Daily healthcare costs decreased to 809 THB/day (IQR 433.48–1,143.09; p < 0.001) with early palliative care. Consultation from palliative care teams significantly reduced unnecessary interventions, such as intubation, surgery, and chemotherapy, particularly in patients receiving late palliative care (p<0.001).
Conclusion: Early palliative care can reduce healthcare utilization and costs during the last month of life and daily expenses for terminal cancer patients. Palliative care consultations also reduce unnecessary procedures in patients receiving late palliative care.
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