Early palliative care associated with lower costs for adults with advanced cancer: evidence from Hungary

被引:3
作者
Zemplenyi, Antal Tamas [1 ,2 ]
Csikos, Agnes [3 ]
Fadgyas-Freyler, Petra [4 ]
Csanadi, Marcell [2 ]
Kalo, Zoltan [2 ,5 ]
Pozsgai, Eva [3 ]
Rutten-van Molken, Maureen [6 ,7 ]
Pitter, Janos Gyorgy [2 ]
机构
[1] Univ Pecs, Fac Pharm, Div Pharmacoecon, Rakoczi St 2, H-7623 Pecs, Hungary
[2] Syreon Res Inst, Budapest, Hungary
[3] Univ Pecs, Med Sch, Inst Primary Hlth Care, Pecs, Hungary
[4] Natl Hlth Insurance Fund, Strateg Anal Dept, Budapest, Hungary
[5] Semmelweis Univ, Ctr Hlth Technol Assessment, Budapest, Hungary
[6] Erasmus Univ, Sch Hlth Policy & Management, Rotterdam, Netherlands
[7] Erasmus Univ, Inst Med Technol Assessment, Rotterdam, Netherlands
基金
欧盟地平线“2020”;
关键词
health care costs; hospice and palliative care nursing; integrated; matched-pair analysis; palliative care; propensity score; LIFE; CONSULTATION; COUNTRIES; HOSPICE; COHORT; END;
D O I
10.1111/ecc.13473
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective Palliative Care Consult Service (PCCS) programme was established in Hungary to provide palliative care to hospitalised patients with complex needs and to coordinate integrated care across providers. The aim of this study was to measure the association of PCCS with healthcare costs from payer's perspective. Methods Study population consisted of patients with metastatic cancer, who were admitted to the Clinical Centre of the University of Pecs between 2014 and 2016. Patients who did not die within 180 days from enrolment were excluded. Patients receiving services from PCCS team (intervention patients) were compared to patients receiving usual care (controls). The two populations were matched using propensity scores. Data were obtained from electronic medical records linked to claims data. Results For patients who were involved in PCCS at least 60 days before their death, the costs of care outside the acute hospital were higher. However, this was offset by savings in hospital costs so that the total healthcare cost was significantly reduced (p = 0.034). The proportion of patients who died in the hospital was lower in the PCCS group compared to the usual care group (66% vs. 85%, p = 0.022). Conclusion Timely initiation of palliative care for hospitalised patients is associated with cost savings for the healthcare system.
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页数:10
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