Cost-efficiency assessment of a community palliative care team in the last week of life

Introduction and objectives: A large portion of the European population prefers to die at home. We evaluated the cost-effectiveness of keeping patients at home with the support of a community palliative care team (CPCT). Study design: Observational, retrospective cohort study without intervention. M...

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Main Authors: Elisabete Costa, Hugo Ribeiro, Júlia Magalhães, João Rocha-Neves, Marília Dourado
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Archives of Gerontology and Geriatrics Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2950307825000384
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author Elisabete Costa
Hugo Ribeiro
Júlia Magalhães
João Rocha-Neves
Marília Dourado
author_facet Elisabete Costa
Hugo Ribeiro
Júlia Magalhães
João Rocha-Neves
Marília Dourado
author_sort Elisabete Costa
collection DOAJ
description Introduction and objectives: A large portion of the European population prefers to die at home. We evaluated the cost-effectiveness of keeping patients at home with the support of a community palliative care team (CPCT). Study design: Observational, retrospective cohort study without intervention. Methods: The clinical records of patients followed during the last week of life by a CPCT in 2021 were evaluated. We performed a cost analysis and compared it with national and international tables for hospitalizations, emergency services and home hospitalization. Results: Costs varied according to the type of care for 84 patients, in a week, it costs 47,488.58 euros in a Palliative Care Unit (PCU) of the National Network for Integrated Continuous Care; 77 195.58 euros in a hospital PCU; and 187 530.885 euros in an acute care or Home Hospitalization Unit. For patients followed by this CPCT, the total cost for providing care to the studied patients was 17 872.499 euros. Furthermore, we observed an improvement in quality of life and symptom control in the transition of care to this CPCT. Conclusions: Patients with advanced and highly complex illnesses can be cared at home with the support of a CPCT like the one that participated in this study, which appears to improve quality of life and symptom control, in addition to ensuring lower costs for the healthcare system. The costs of other units were 3 to more than 10 times higher than the value presented by the CPCT. Aligned with the patient's will, there is a cost-effectiveness advantage in keeping high clinically complex patients at home.
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spelling doaj-art-c02f5a169da24bb7b25c851945a8a7d92025-08-20T03:12:28ZengElsevierArchives of Gerontology and Geriatrics Plus2950-30782025-06-012210015610.1016/j.aggp.2025.100156Cost-efficiency assessment of a community palliative care team in the last week of lifeElisabete Costa0Hugo Ribeiro1Júlia Magalhães2João Rocha-Neves3Marília Dourado4Community Palliative Care Support Team Gaia, Vila Nova de Gaia, Portugal; Faculty of Medicine of University of Coimbra, Coimbra, PortugalCommunity Palliative Care Support Team Gaia, Vila Nova de Gaia, Portugal; Faculty of Medicine of University of Coimbra, Coimbra, Portugal; Centre for Innovative Biomedicine and Biotechnology, Coimbra, Portugal; Faculty of Medicine of University of Porto, Porto, Portugal; Corresponding author at: R. Bartolomeu Dias 316, 4430-043 Vila Nova de Gaia, Portugal.Community Palliative Care Support Team Gaia, Vila Nova de Gaia, PortugalFaculty of Medicine of University of Porto, Porto, Portugal; Department of Biomedicine – Unit of Anatomy - Faculty of Medicine of University of Porto, Porto, Portugal; CINTESIS@Rise, Porto, PortugalFaculty of Medicine of University of Coimbra, Coimbra, Portugal; Centre for Innovative Biomedicine and Biotechnology, Coimbra, PortugalIntroduction and objectives: A large portion of the European population prefers to die at home. We evaluated the cost-effectiveness of keeping patients at home with the support of a community palliative care team (CPCT). Study design: Observational, retrospective cohort study without intervention. Methods: The clinical records of patients followed during the last week of life by a CPCT in 2021 were evaluated. We performed a cost analysis and compared it with national and international tables for hospitalizations, emergency services and home hospitalization. Results: Costs varied according to the type of care for 84 patients, in a week, it costs 47,488.58 euros in a Palliative Care Unit (PCU) of the National Network for Integrated Continuous Care; 77 195.58 euros in a hospital PCU; and 187 530.885 euros in an acute care or Home Hospitalization Unit. For patients followed by this CPCT, the total cost for providing care to the studied patients was 17 872.499 euros. Furthermore, we observed an improvement in quality of life and symptom control in the transition of care to this CPCT. Conclusions: Patients with advanced and highly complex illnesses can be cared at home with the support of a CPCT like the one that participated in this study, which appears to improve quality of life and symptom control, in addition to ensuring lower costs for the healthcare system. The costs of other units were 3 to more than 10 times higher than the value presented by the CPCT. Aligned with the patient's will, there is a cost-effectiveness advantage in keeping high clinically complex patients at home.http://www.sciencedirect.com/science/article/pii/S2950307825000384End-of-life careEfficiencyHealthcare costsHome careHealth policy
spellingShingle Elisabete Costa
Hugo Ribeiro
Júlia Magalhães
João Rocha-Neves
Marília Dourado
Cost-efficiency assessment of a community palliative care team in the last week of life
Archives of Gerontology and Geriatrics Plus
End-of-life care
Efficiency
Healthcare costs
Home care
Health policy
title Cost-efficiency assessment of a community palliative care team in the last week of life
title_full Cost-efficiency assessment of a community palliative care team in the last week of life
title_fullStr Cost-efficiency assessment of a community palliative care team in the last week of life
title_full_unstemmed Cost-efficiency assessment of a community palliative care team in the last week of life
title_short Cost-efficiency assessment of a community palliative care team in the last week of life
title_sort cost efficiency assessment of a community palliative care team in the last week of life
topic End-of-life care
Efficiency
Healthcare costs
Home care
Health policy
url http://www.sciencedirect.com/science/article/pii/S2950307825000384
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