Oncology and Palliative Care Integration Model: A Cost Analysis Study in a Brazilian Hospital Setting

Area of Science:

• Oncology
• Palliative Care
• Health Services Research

Background:

• São Paulo State Cancer Institute (ICESP) introduced an integrated Oncology and Palliative Care model in 2019.
• This study evaluates the impact of this integrated model on healthcare resource utilization and associated costs.

Purpose of the Study:

• To assess the effect of integrating palliative care specialists into oncology care on healthcare resource utilization and costs.
• To determine if this integrated model reduces potentially inappropriate treatments in the final month of life.

Main Methods:

• Retrospective analysis of patients who died at ICESP in February (pre-implementation) and November (post-implementation).
• Data on healthcare utilization (emergency visits, hospital/ICU admissions, chemotherapy, radiotherapy) extracted from Electronic Medical Records.
• Unit costs obtained from administrative databases to calculate total healthcare costs.

Main Results:

• Mean cost per patient decreased from US$13,226.29 to US$11,445.82 post-integration (P = .007).
• Significant reductions observed in surgical ward days, emergency department visits, chemotherapy, and radiotherapy sessions.
• Costs for chemotherapy and radiotherapy in the last 30 days of life dropped from US$16,924.45 to US$7851.65.
• Reductions were more significant in patients with ECOG 3-4.

Conclusions:

• The integrated Oncology and Palliative Care model is associated with reduced healthcare utilization and costs.
• This model appears to decrease the delivery of potentially inappropriate treatments during the end of life.
• Findings suggest benefits for both patient care and healthcare resource management.