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Evidence on the economic value of end-of-life and palliative care interventions : a narrative review of reviews

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Date
23/06/2021
Author
Luta, Xhyljeta
Ottino, Baptiste
Hall, Peter
Bowden, Joanna
Wee, Bee
Droney, Joanne
Riley, Julia
Marti, Joachim
Keywords
End-of-life care
Terminal care
Palliative care
Cost-effectiveness
Health care costs
RA Public aspects of medicine
RC0254 Neoplasms. Tumors. Oncology (including Cancer)
NIS
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Abstract
Background: As the demand for palliative care increases, more information is needed on how efficient different types of palliative care models are for providing care to dying patients and their caregivers. Evidence on the economic value of treatments and interventions is key to informing resource allocation and ultimately improving the quality and efficiency of healthcare delivery. We assessed the available evidence on the economic value of palliative and end-of-life care interventions across various settings. Methods: Reviews published between 2000 and 2019 were included. We included reviews that focused on cost-effectiveness, intervention costs and/or healthcare resource use. Two reviewers extracted data independently and in duplicate from the included studies. Data on the key characteristics of the studies were extracted, including the aim of the study, design, population, type of intervention and comparator, (cost-) effectiveness resource use, main findings and conclusions. Results: A total of 43 reviews were included in the analysis. Overall, most evidence on cost-effectiveness relates to home-based interventions and suggests that they offer substantial savings to the health system, including a decrease in total healthcare costs, resource use and improvement in patient and caregivers’ outcomes. The evidence of interventions delivered across other settings was generally inconsistent. Conclusions: Some palliative care models may contribute to dual improvement in quality of care via lower rates of aggressive medicalization in the last phase of life accompanied by a reduction in costs. Hospital-based palliative care interventions may improve patient outcomes, healthcare utilization and costs. There is a need for greater consistency in reporting outcome measures, the informal costs of caring, and costs associated with hospice.
Citation
Luta , X , Ottino , B , Hall , P , Bowden , J , Wee , B , Droney , J , Riley , J & Marti , J 2021 , ' Evidence on the economic value of end-of-life and palliative care interventions : a narrative review of reviews ' , BMC Palliative Care , vol. 20 , no. 1 , 89 . https://doi.org/10.1186/s12904-021-00782-7
Publication
BMC Palliative Care
Status
Peer reviewed
DOI
https://doi.org/10.1186/s12904-021-00782-7
ISSN
1472-684X
Type
Journal item
Rights
Copyright © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
Description
This work was supported by the Health Foundation (www.health.org.uk).
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  • University of St Andrews Research
URI
http://hdl.handle.net/10023/23475

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