Cost-efficiency assessment of a community palliative care team in the last week of life

Abstract

Introduction and objectives

A large portion of the European population prefers to die at home. We evaluated the cost-effectiveness of keeping patients at home with the support of a community palliative care team (CPCT).

Study design

Observational, retrospective cohort study without intervention.

Methods

The clinical records of patients followed during the last week of life by a CPCT in 2021 were evaluated. We performed a cost analysis and compared it with national and international tables for hospitalizations, emergency services and home hospitalization.

Results

Costs varied according to the type of care for 84 patients, in a week, it costs 47,488.58 euros in a Palliative Care Unit (PCU) of the National Network for Integrated Continuous Care; 77 195.58 euros in a hospital PCU; and 187 530.885 euros in an acute care or Home Hospitalization Unit. For patients followed by this CPCT, the total cost for providing care to the studied patients was 17 872.499 euros. Furthermore, we observed an improvement in quality of life and symptom control in the transition of care to this CPCT.

Conclusions

Patients with advanced and highly complex illnesses can be cared at home with the support of a CPCT like the one that participated in this study, which appears to improve quality of life and symptom control, in addition to ensuring lower costs for the healthcare system. The costs of other units were 3 to more than 10 times higher than the value presented by the CPCT. Aligned with the patient's will, there is a cost-effectiveness advantage in keeping high clinically complex patients at home.