The association between palliative care team consultation and hospital costs for patients with advanced cancer: An observational study in 12 Dutch hospitals.
Eur J Cancer Care (Engl)
; 29(3): e13198, 2020 May.
Article
en En
| MEDLINE
| ID: mdl-31825156
ABSTRACT
BACKGROUND:
Early palliative care team consultation has been shown to reduce costs of hospital care. The objective of this study was to investigate the association between palliative care team (PCT) consultation and the content and costs of hospital care in patients with advanced cancer. MATERIAL ANDMETHODS:
A prospective, observational study was conducted in 12 Dutch hospitals. Patients with advanced cancer and an estimated life expectancy of less than 1 year were included. We compared hospital care during 3 months of follow-up for patients with and without PCT involvement. Propensity score matching was used to estimate the effect of PCTs on costs of hospital care. Additionally, gamma regression models were estimated to assess predictors of hospital costs.RESULTS:
We included 535 patients of whom 126 received PCT consultation. Patients with PCT had a worse life expectancy (life expectancy <3 months 62% vs. 31%, p < .01) and performance status (p < .01, e.g., WHO status higher than 254% vs. 28%) and more often had no more options for anti-tumour therapy (57% vs. 30%, p < .01). Hospital length of stay, use of most diagnostic procedures, medication and other therapeutic interventions were similar. The total mean hospital costs were 8,393 for patients with and 8,631 for patients without PCT consultation. Analyses using propensity scores to control for observed confounding showed no significant difference in hospital costs.CONCLUSIONS:
PCT consultation for patients with cancer in Dutch hospitals often occurs late in the patients' disease trajectories, which might explain why we found no effect of PCT consultation on costs of hospital care. Earlier consultation could be beneficial to patients and reduce costs of care.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Cuidados Paliativos
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Derivación y Consulta
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Costos de Hospital
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Tiempo de Internación
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Neoplasias
Tipo de estudio:
Diagnostic_studies
/
Health_economic_evaluation
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur J Cancer Care (Engl)
Asunto de la revista:
ENFERMAGEM
/
NEOPLASIAS
Año:
2020
Tipo del documento:
Article
País de afiliación:
Países Bajos