Is home-based palliative care cost effective? An economic evaluation of the Palliative Care Extended Packages at Home (PEACH) pilot
RIS ID
78058
Abstract
Objective The aim of this study was to evaluate the cost-effectiveness of a home-based palliative care model relative to usual care in expediting discharge or enabling patients to remain at home.
Design Economic evaluation of a pilot randomised controlled trial with 28 days follow-up.
Methods Mean costs and effectiveness were calculated for the Palliative Care Extended Packages at Home (PEACH) and usual care arms including: days at home; place of death; PEACH intervention costs; specialist palliative care service use; acute hospital and palliative care unit inpatient stays; and outpatient visits.
Results PEACH mean intervention costs per patient ($3489) were largely offset by lower mean inpatient care costs ($2450) and in this arm, participants were at home for one additional day on average. Consequently, PEACH is cost-effective relative to usual care when the threshold value for one extra day at home exceeds $1068, or $2547 if only within-study days of hospital admission are costed. All estimates are high uncertainty.
Conclusions The results of this small pilot study point to the potential of PEACH as a cost-effective end-of-life care model relative to usual care. Findings support the feasibility of conducting a definitive, fully powered study with longer follow-up and comprehensive economic evaluation.
Publication Details
N. McCaffrey, M. Agar, J. Harlum, J. Karnon, D. Currow & S. Eckermann, "Is home-based palliative care cost effective? An economic evaluation of the Palliative Care Extended Packages at Home (PEACH) pilot", BMJ Supportive & Palliative Care 3 4 (2013) 431-435.