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21.05.2020 | Review Article

The health care cost of palliative care for cancer patients: a systematic review

verfasst von: Sandhya Yadav, Isaac W. Heller, Nancy Schaefer, Ramzi G. Salloum, Sheri M. Kittelson, Diana J. Wilkie, Jinhai Huo

Erschienen in: Supportive Care in Cancer | Ausgabe 10/2020

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Abstract

Objectives

Several delivery models of palliative care are currently available: hospital-based, outpatient-based, home-based, nursing home-based, and hospice-based. Weighing the differences in costs of these delivery models helps to advise on the future direction of expanding palliative care services. The objective of this review is to identify and summarize the best available evidence in the US on cost associated with palliative care for patients diagnosed with cancer.

Methods

The systematic review was carried out of studies conducted in the US between 2008 and 2018, searching PubMed, Medline, the Cochrane library, CINAHL, EconLit, the Social Science Citation Index, Embase, and Science Citation Index, using the following terms: palliative, cancer, carcinoma, cost, and reimbursement.

Results

The initial search identified 748 articles, of which 16 met the inclusion criteria. Eight studies (50%) were inpatient-based, four (25%) were combined outpatient/inpatient, two (12.5%) reported only on home-based palliative services, and two (12.5%) were in multiple settings. Most included studies showed that palliative care reduced the cost of health care by $1285–$20,719 for inpatient palliative care, $1000–$5198 for outpatient and inpatient combined, $4258 for home-based, and $117–$400 per day for home/hospice, combined outpatient/inpatient palliative care.

Conclusion

Receiving palliative care after a cancer diagnosis was associated with lower costs for cancer patients, and remarkable differences exist in cost saving across different palliative care models.

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Hughes MT, Smith TJ (2014) The growth of palliative care in the United States. Annu Rev Public Health 35(1):459–475. https://doi.org/10.1146/annurev-publhealth-032013-182406CrossRefPubMed

Dumanovsky T, Augustin R, Rogers M, Lettang K, Meier DE, Morrison RS (2016) The growth of palliative care in U.S. hospitals: a status report. J Palliat Med 19(1):8–15. https://doi.org/10.1089/jpm.2015.0351CrossRefPubMedPubMedCentral

Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM, Firn JI, Paice JA, Peppercorn JM, Phillips T, Stovall EL. Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology 35(1):96

Sepúlveda C, Marlin A, Yoshida T, Ullrich A 2002 Palliative care: the World Health Organization's global perspective. Journal of Pain and Symptom Management 24(2):91–6

Zimmermann C, Swami N, Krzyzanowska M, Hannon B, Leighl N, Oza A, Moore M, Rydall A, Rodin G, Tannock I, Donner A, Lo C (2014) Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet. 383(9930):1721–1730. https://doi.org/10.1016/S0140-6736(13)62416-2CrossRefPubMed

Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ (2010) Early palliative care for patients with metastatic non–small-cell lung cancer. N Engl J Med 363(8):733–742. https://doi.org/10.1056/NEJMoa1000678CrossRefPubMed

Scibetta C, Kerr K, Mcguire J, Rabow MW (2016) The costs of waiting: implications of the timing of palliative care consultation among a cohort of decedents at a comprehensive cancer center. J Palliat Med 19(1):69–75. https://doi.org/10.1089/jpm.2015.0119CrossRefPubMed

Colligan EM, Ewald E, Ruiz S, Spafford M, Cross-Barnet C, Parashuram S (2017) Innovative oncology care models improve end-of-life quality, reduce utilization and spending. Health Aff 36(3):433–440. https://doi.org/10.1377/hlthaff.2016.1303CrossRef

Lowery WJ, Lowery AW, Barnett JC, Lopez-Acevedo M, Lee PS, Secord AA, Havrilesky L (2013) Cost-effectiveness of early palliative care intervention in recurrent platinum-resistant ovarian cancer. Gynecol Oncol 130(3):426–430. https://doi.org/10.1016/J.YGYNO.2013.06.011CrossRefPubMed

10.

Bakitas M, Lyons KD, Hegel MT, Balan S, Brokaw FC, Seville J, Hull JG, Li Z, Tosteson TD, Byock IR, Ahles TA (2009) Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer. JAMA. 302(7):741–749. https://doi.org/10.1001/jama.2009.1198CrossRefPubMedPubMedCentral

11.

Grudzen CR, Richardson LD, Johnson PN, Hu M, Wang B, Ortiz JM, Kistler EA, Chen A, Morrison RS (2016) Emergency department–initiated palliative care in advanced cancer. JAMA Oncol 2(5):591–598. https://doi.org/10.1001/jamaoncol.2015.5252CrossRefPubMed

12.

Greer JA, Tramontano AC, McMahon PM et al (2016) Cost analysis of a randomized trial of early palliative care in patients with metastatic nonsmall-cell lung cancer. J Palliat Med 19(8):842–848. https://doi.org/10.1089/jpm.2015.0476CrossRefPubMed

13.

Henk HJ, Chen C, Benedict A, Sullivan J, Teitelbaum A (2013) Retrospective claims analysis of best supportive care costs and survival in a US metastatic renal cell population. Clin Econ Outcomes Res 5:347. https://doi.org/10.2147/CEOR.S45756CrossRef

14.

Connor SR, Pyenson B, Fitch K, Spence C, Iwasaki K (2007) Comparing hospice and nonhospice patient survival among patients who die within a three-year window. J Pain Symptom Manag 33(3):238–246. https://doi.org/10.1016/J.JPAINSYMMAN.2006.10.010CrossRef

15.

May P, Garrido MM, Cassel JB, Kelley AS, Meier DE, Normand C, Smith TJ, Morrison RS (2017) Cost analysis of a prospective multi-site cohort study of palliative care consultation teams for adults with advanced cancer: where do cost-savings come from? Palliat Med 31(4):378–386. https://doi.org/10.1177/0269216317690098CrossRefPubMed

16.

May P, Garrido MM, Cassel JB, Kelley AS, Meier DE, Normand C, Stefanis L, Smith TJ, Morrison RS (2016) Palliative care teams’ cost-saving effect is larger for cancer patients with higher numbers of comorbidities. Health Aff 35(1):44–53. https://doi.org/10.1377/hlthaff.2015.0752CrossRef

17.

Gade G, Venohr I, Conner D, McGrady K, Beane J, Richardson RH, Williams MP, Liberson M, Blum M, Penna RD (2008) Impact of an inpatient palliative care team: a randomized controlled trial. J Palliat Med 11(2):180–190. https://doi.org/10.1089/jpm.2007.0055CrossRefPubMed

18.

Cassel JB, Webb-Wright J, Holmes J, Lyckholm L, Smith TJ (2010) Clinical and financial impact of a palliative care program at a small rural hospital. J Palliat Med 13(11):1339–1343. https://doi.org/10.1089/jpm.2010.0155CrossRefPubMed

19.

Ferrell BR, Temel JS, Temin S, Smith TJ (2017) Integration of palliative care into standard oncology care: ASCO clinical practice guideline update summary. J Oncol Pract 13(2):119–121

20.

Postier A, Chrastek J, Nugent S, Osenga K, Friedrichsdorf SJ (2014) Exposure to home-based pediatric palliative and hospice care and its impact on hospital and emergency care charges at a single institution. J Palliat Med 17(2):183–188. https://doi.org/10.1089/jpm.2013.0287CrossRefPubMed

21.

May P, Normand C, Morrison RS (2014) Economic impact of hospital inpatient palliative care consultation: review of current evidence and directions for future research. J Palliat Med 17(9):1054–1063. https://doi.org/10.1089/jpm.2013.0594CrossRefPubMedPubMedCentral

22.

Temel JS, Greer JA, Admane S, Gallagher ER, Jackson VA, Lynch TJ, Lennes IT, Dahlin CM, Pirl WF (2011) Longitudinal perceptions of prognosis and goals of therapy in patients with metastatic non-small-cell lung cancer: results of a randomized study of early palliative care. J Clin Oncol 29(17):2319–2326. https://doi.org/10.1200/JCO.2010.32.4459CrossRefPubMed

23.

Elsayem A, Swint K, Fisch MJ, Palmer JL, Reddy S, Walker P, Zhukovsky D, Knight P, Bruera E (2004) Palliative care inpatient service in a comprehensive cancer center: clinical and financial outcomes. J Clin Oncol 22(10):2008–2014. https://doi.org/10.1200/JCO.2004.11.003CrossRefPubMed

24.

Blackhall LJ, Read P, Stukenborg G, Dillon P, Barclay J, Romano A, Harrison J (2016) CARE track for advanced cancer: impact and timing of an outpatient palliative care clinic. J Palliat Med 19(1):57–63. https://doi.org/10.1089/jpm.2015.0272CrossRefPubMedPubMedCentral

25.

Pirl W (2011) Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer addressing psychological distress in parents of children with cancer view project building resiliency in a Palliative Care Team View project. Artic J Clin Oncol 30:394–400. https://doi.org/10.1200/JCO.2011.35.7996CrossRef

26.

Ruck JM, Canner JK, Smith TJ, Johnston FM (2018) Use of inpatient palliative care by type of malignancy. J Palliat Med 21(9):1300–1307. https://doi.org/10.1089/jpm.2018.0003CrossRefPubMedPubMedCentral

27.

May P, Garrido MM, Cassel JB, Kelley AS, Meier DE, Normand C, Smith TJ, Stefanis L, Morrison RS (2015) Prospective cohort study of hospital palliative care teams for inpatients with advanced cancer: earlier consultation is associated with larger cost-saving effect. J Clin Oncol 33(25):2745–2752. https://doi.org/10.1200/JCO.2014.60.2334CrossRefPubMedPubMedCentral

28.

Bhulani N, Gupta A, Gao A et al (2018) Palliative care and end-of-life health care utilization in elderly patients with pancreatic cancer. J Gastrointest Oncol 9(3):495–502. https://doi.org/10.21037/jgo.2018.03.08CrossRefPubMedPubMedCentral

29.

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135CrossRefPubMed

30.

Richardson WS, Wilson MC, Nishikawa J, Hayward RS (1995) The well-built clinical question: a key to evidence-based decisions. ACP J Club 123(3). https://doi.org/10.7326/ACPJC-1995-123-3-A12

31.

Bekelman JE, Halpern SD, Blankart CR, Bynum JP, Cohen J, Fowler R, Kaasa S, Kwietniewski L, Melberg HO, Onwuteaka-Philipsen B, Oosterveld-Vlug M, Pring A, Schreyögg J, Ulrich CM, Verne J, Wunsch H, Emanuel EJ, for the International Consortium for End-of-Life Research (ICELR) (2016) Comparison of site of death, health care utilization, and hospital expenditures for patients dying with cancer in 7 developed countries. JAMA 315(3):272–283. https://doi.org/10.1001/jama.2015.18603CrossRefPubMed

32.

Schardt C, Adams MB, Owens T, Keitz S, Fontelo P (2007) Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak 7. https://doi.org/10.1186/1472-6947-7-16

33.

Smith S, Brick A, O’Hara S, Normand C (2014) Evidence on the cost and cost-effectiveness of palliative care: a literature review. Palliat Med 28(2):130–150. https://doi.org/10.1177/0269216313493466CrossRefPubMed

34.

Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, Augustovski F, Briggs AH, Mauskopf J, Loder E, CHEERS Task Force (2013) Consolidated health economic evaluation reporting standards (cheers) statement. Int J Technol Assess Health Care 29(2):117–122. https://doi.org/10.1017/S0266462313000160CrossRefPubMed

35.

Brian Cassel J, Kerr KM, McClish DK et al (2016) Effect of a home-based palliative care program on healthcare use and costs. J Am Geriatr Soc 64(11):2288–2295. https://doi.org/10.1111/jgs.14354CrossRefPubMedPubMedCentral

36.

Chang S, May P, Goldstein NE, Wisnivesky J, Ricks D, Fuld D, Aldridge M, Rosenzweig K, Morrison RS, Dharmarajan KV (2018) A palliative radiation oncology consult service reduces total costs during hospitalization. J Pain Symptom Manag 55(6):1452–1458. https://doi.org/10.1016/J.JPAINSYMMAN.2018.03.005CrossRef

37.

McCarthy IM, Robinson C, Huq S, Philastre M, Fine RL (2015) Cost savings from palliative care teams and guidance for a financially viable palliative care program. Health Serv Res 50(1):217–236. https://doi.org/10.1111/1475-6773.12203CrossRefPubMed

38.

Morrison RS, Penrod JD, Cassel JB, Caust-Ellenbogen M, Litke A, Spragens L, Meier DE, Palliative Care Leadership Centers' Outcomes Group (2008) Cost savings associated with US hospital palliative care consultation programs. Arch Intern Med 168(16):1783–1790. https://doi.org/10.1001/archinte.168.16.1783CrossRefPubMed

39.

Mulvey CL, Smith TJ, Gourin CG (2016) Use of inpatient palliative care services in patients with metastatic incurable head and neck cancer. Head Neck 38(3):355–363. https://doi.org/10.1002/hed.23895CrossRefPubMed

40.

Nijboer C, Triemstra M, Tempelaar R, Sanderman R, van den Bos GA (1999) Measuring both negative and positive reactions to giving care to cancer patients: psychometric qualities of the Caregiver Reaction Assessment (CRA). Soc Sci Med 48(9):1259–1269. https://doi.org/10.1016/S0277-9536(98)00426-2CrossRefPubMed

Titel: The health care cost of palliative care for cancer patients: a systematic review
verfasst von: Sandhya Yadav
Isaac W. Heller
Nancy Schaefer
Ramzi G. Salloum
Sheri M. Kittelson
Diana J. Wilkie
Jinhai Huo
Publikationsdatum: 21.05.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 10/2020
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-020-05512-y

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The health care cost of palliative care for cancer patients: a systematic review

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