Direct Hospitalisation Costs of End-of-Life Cancer Care: Comparison Between Usual Care and Palliative Care...

Purpose: This study aimed to compare direct hospitalisation costs for patients with cancer during terminal hospitalisation between those receiving palliative care consultation and those receiving usual care. Methods: A retrospective medical record review was conducted to obtain clinical information and cost data for patients with cancer during terminal hospitalisation. Hospitalisation costs between the palliative care and usual care groups were compared using analytical statistics. Effect sizes for cost comparisons were presented as median differences. Results: A total of 154 and 112 patients were classified into the palliative care group and the usual care group, respectively. Patients in the palliative care group had a longer length of hospital stay than those in the usual care group (8 days vs. 3 days, p < 0.001). Compared with usual care, patients receiving palliative care had lower utilisation of the intensive care unit (ICU) (8.4% vs. 44.6%, p < 0.001), invasive mechanical ventilation (4.5% vs. 36.6%, p < 0.001), cardiopulmonary resuscitation (1.9% vs. 8.9%, p = 0.020), and vasopressors and inotropes (7.1% vs. 25.9%, p < 0.001). Total hospitalisation costs did not differ significantly between palliative care and usual care groups (27,910.8 vs. 24,216.4 Thai Baht (THB), p = 0.305). However, the palliative care group had significantly lower daily hospitalisation costs (3587.4 vs. 6918.2 THB/day, p < 0.001). Median daily costs were lower in the palliative care group for breast cancer (3326.8 vs. 8049.0 THB/day; median difference -4390.1, p = 0.016), colorectal cancer (3422.8 vs. 5595.0 THB/day; median difference -2500.7, p = 0.008), hepato-pancreatico-biliary cancer (3611.7 vs. 5097.0 THB/day; median difference -1740.0, p = 0.004), and lung cancer (3435.4 vs. 7998.7 THB/day; median difference -3896.5, p < 0.001). Conclusions: Palliative care consultation was associated with lower direct daily hospitalisation costs during end-of-life cancer care.