End of Life Cost Savings in the Palliative Care Unit Compared to Other Services

• Published in: Journal of pain and symptom management Vol. 64; no. 5; pp. 495 - 503
• Main Authors: Abian, María Herrera, Antón Rodríguez, Cristina, Noguera, Antonio
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2022
• Subjects: cost; Cost Savings; Death; Hospice and Palliative Care Nursing; hospital; Humans; inpatient; Palliative care; Palliative Care - methods; Retrospective Studies; unit; Palliative care; unit; cost; death; hospital; inpatient
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2022.06.016

Hospital deaths carry a significant healthcare cost that has been confirmed to be lower when palliative care units (PCUs) are available.
To compare the last admission hospital health care cost of dying in a first-level hospital between the PCU and the rest of the hospital services.
A retrospective, comparative, observational study evaluating costs from the payer perspective on treatments and diagnostic-therapeutic tests performed on patients who die in first-level hospital, comparing whether they were treated by the PCU or another unit (Non-PCU). Patients with a mortality risk >2 were included according to the Severity of Illness Index (SOI) and Risk of Mortality (MOR). All cost express in €, median per patient and interquartile range (IQR).
From 1,833 patients who died, 1,389 were included, 442 (31.1%) treated by PCU and 928 (68.9%) Non-PCU. Statistical differences were found for the last admission total cost (€262.8 (€470.1) for PCU versus €515.3 (€980.48) in Non-PCU), daily total cost (€74.27 (€127.4) vs €115.8 (€142.4) Non-PCU). Savings were maintained when the sample was broken down by diagnosis-related group (DRG) and a multivariate analysis was performed to determine how the different patients baseline characteristics between PCU and Non-PCU patients influenced the results obtained.
Data from this study show that cost is significantly lower when the patients are treated by a PCU during their last hospital stay when they pass away.