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The association between palliative care team consultation and hospital costs for patients with advanced cancer: An observational study in 12 Dutch hospitals
Author(s) -
BrinkmanStoppelenburg Arianne,
Polinder Suzanne,
Olij Branko F.,
den Berg Barbara,
Gunnink Nicolette,
Hendriks Mathijs P.,
Linden Yvette M.,
Nieboer Daan,
PadtPruijsten Annemieke,
Peters Liesbeth A.,
Roggeveen Brenda,
Terheggen Frederiek,
Verhage Sylvia,
Vorst Maurice J.,
Willemen Ingrid,
Vergouwe Yvonne,
Heide Agnes
Publication year - 2020
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.13198
Subject(s) - medicine , observational study , propensity score matching , confounding , palliative care , life expectancy , logistic regression , emergency medicine , psychological intervention , cancer , nursing , population , environmental health
Background Early palliative care team consultation has been shown to reduce costs of hospital care. The objective of this study was to investigate the association between palliative care team (PCT) consultation and the content and costs of hospital care in patients with advanced cancer. Material and Methods A prospective, observational study was conducted in 12 Dutch hospitals. Patients with advanced cancer and an estimated life expectancy of less than 1 year were included. We compared hospital care during 3 months of follow‐up for patients with and without PCT involvement. Propensity score matching was used to estimate the effect of PCTs on costs of hospital care. Additionally, gamma regression models were estimated to assess predictors of hospital costs. Results We included 535 patients of whom 126 received PCT consultation. Patients with PCT had a worse life expectancy (life expectancy <3 months: 62% vs. 31%, p < .01) and performance status ( p < .01, e.g., WHO status higher than 2:54% vs. 28%) and more often had no more options for anti‐tumour therapy (57% vs. 30%, p < .01). Hospital length of stay, use of most diagnostic procedures, medication and other therapeutic interventions were similar. The total mean hospital costs were €8,393 for patients with and €8,631 for patients without PCT consultation. Analyses using propensity scores to control for observed confounding showed no significant difference in hospital costs. Conclusions PCT consultation for patients with cancer in Dutch hospitals often occurs late in the patients’ disease trajectories, which might explain why we found no effect of PCT consultation on costs of hospital care. Earlier consultation could be beneficial to patients and reduce costs of care.