Palliative Care Costs in Different Ambulatory-Based Settings: A Systematic Review

Area of Science:

• Health Economics
• Palliative Care Research
• Economic Evaluation

Background:

• Cost-of-illness studies in palliative care are gaining traction in health economics.
• A standardized methodology for capturing all direct and indirect costs in ambulatory palliative care is currently lacking.
• This includes expenses for healthcare services, patients, and their caregivers.

Approach:

• A systematic review was conducted on studies published between January 2000 and December 2022.
• Data were sourced from six bibliographic databases, including PubMed, EMBASE, and Google Scholar.
• Study selection followed PRISMA guidelines, and quality was assessed using the Health Economic Studies instrument.

Key Points:

• 43 articles met inclusion criteria, with most studies using retrospective, bottom-up costing from a healthcare system perspective.
• Direct healthcare costs were reported in nearly all studies, with inpatient care being the primary cost driver.
• Caregiver productivity losses were reported in 20.97% of studies, with costs analyzed via opportunity cost.

Conclusions:

• Studies on ambulatory palliative care costs are increasing, predominantly from a healthcare system viewpoint.
• This perspective overlooks the economic burden on patients and caregivers.
• Prospective studies using a societal perspective are needed to accurately assess financial impact and inform interventions.