TITLE:
Economic Evaluation of the Palliative Care Home Support Packages Program
AUTHORS:
Josephine Sau Fan Chow, Kim Jobburn, Janeane Harlum, Meera Agar
KEYWORDS:
Cost-Effectiveness, Economic, Home Death, Palliative Care Extended Packages at Home, Palliative Care, Usual Care
JOURNAL NAME:
Journal of Service Science and Management,
Vol.15 No.5,
October
21,
2022
ABSTRACT: Background: Economic evidence in palliative care is important
for making decisions regarding allocation of resources and support patient
preferences for end-of-life (EOL) care.
However, there is limited evidence on the cost-effectiveness of
palliative and EOL models of care to inform healthcare funding decisions. Aim: To evaluate the cost-effectiveness of providing Palliative Care Extended
Packages at Home (PEACH) in addition to usual care to support clients in their
wish to be cared for, and die at home. Design: A modelled cost-effectiveness analysis was conducted from a
healthcare provider perspective to estimate the incremental costs, effects
and cost effectiveness. Setting/participants: De-identified prospective
and retrospective data on the resource use, cost and consequences of the PEACH
Packages Program (n = 75) and usual care (n = 95) were collected from three
participating local health districts (LHD) data information systems. Results: Mean costs per patient of providing PEACH ($3493) in addition to usual care
were offset by lower mean inpatient care ($6392) and emergency department
presentation costs ($139). On average, patients receiving PEACH spent an
additional four days at home in the last week of life and more died at home
(95% vs 49%). If a daily PEACH cost is applied rather than a per package cost,
additional savings of $52,544 may be realised. Better prognostic tools could
also result in further savings. Conclusions: PEACH is a cost-effective
model of care when added to usual care for people in the last week of life as
PEACH plus usual care is more effective and less costly than usual care alone.