The health care cost of palliative care for cancer patients: a systematic review
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REVIEW ARTICLE
The health care cost of palliative care for cancer patients: a systematic review Sandhya Yadav 1 Jinhai Huo 1
&
Isaac W. Heller 1 & Nancy Schaefer 2 & Ramzi G. Salloum 3 & Sheri M. Kittelson 4 & Diana J. Wilkie 5 &
Received: 3 February 2020 / Accepted: 5 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
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. Keywords Palliative care . Cost . Cancer . Systematic review
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00520-020-05512-y) contains supplementary material, which is available to authorized users. * Sandhya Yadav [email protected] 1
Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, 1225 Center Drive, HPNP 3111, PO Box 100195, Gainesville, FL 32610, USA
2
Health Science Center Libraries, The George A. Smathers Libraries, University of Florida, Gainesville, FL, USA
3
Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
4
Palliative Care Program, College of Medicine, University of Florida, Gainesville, FL, USA
5
Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
Palliative care as a medical specialty focusing on care for advanced cancer patients is growing at a rapid rate in the United States [1, 2]. The American Society of Clinical Oncology (A
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