Cost Savings Associated With Palliative Care Among Older Adults With Advanced Cancer.
Cost Savings Associated With Palliative Care Among Older Adults With Advanced Cancer.
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DOI：
10.1177/1049909120986800
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Murphy JD
中科院分区：
文献类型：
--
作者：
Sheridan PE;LeBrett WG;Triplett DP;Roeland EJ;Bruggeman AR;Yeung HN;Murphy JD
没有不一致的证据表明姑息治疗干预可以减少肿瘤患者临终时的总医疗支出。这种不一致的证据可能是由于单个机构研究的样本量较小以及不同研究的成本特征不同造成的。需要对基于人群的数据集进行全面研究，以充分了解姑息治疗对总医疗费用的影响。这项研究分析了姑息治疗对全国代表性晚期癌症患者样本的总医疗费用的影响。我们在患有转移性肺癌、结直肠癌、乳腺癌和前列腺癌的医疗保险患者中进行了一项匹配队列研究。我们根据与接受姑息治疗和临终费用相关的因素，将接受姑息治疗咨询的患者与未接受姑息治疗咨询的类似患者进行匹配。我们比较了匹配患者之间的直接成本，以确定姑息治疗咨询对每个患者的经济影响。接受姑息治疗咨询的患者的平均每位患者费用为 5,834 美元，而常规护理患者的每位患者费用为 7,784 美元（下降 25%；p<0.0001）。死亡后 7 天内的姑息治疗咨询将医疗费用减少了 451 美元，而死亡后 4 周以上的姑息治疗咨询将医疗费用减少了 4,643 美元。这项研究表明，姑息治疗能够大幅减少晚期癌症患者的医疗支出。与生命最后一周的咨询相比，较早的姑息治疗咨询可以减少更多的费用。
There is inconsistent evidence that palliative care intervention decreases total healthcare expenditure at end-of-life for oncology patients. This inconsistent evidence may result from small sample sizes at single institution studies and disparate characterization of costs across studies. Comprehensive studies in population-based datasets are needed to fully understand the impact of palliative care on total healthcare costs. This study analyzed the impact of palliative care on total healthcare costs in a nationally representative sample of advanced cancer patients. We conducted a matched cohort study among Medicare patients with metastatic lung, colorectal, breast and prostate cancers. We matched patients who received a palliative care consultation to similar patients who did not receive a palliative care consultation on factors related to both the receipt of palliative care and end of life costs. We compared direct costs between matched patients to determine the per-patient economic impact of a palliative care consultation. Patients who received a palliative care consultation experienced an average per patient cost of $5,834 compared to $7,784 for usual care patients (25% decrease; p<0.0001). Palliative care consultation within 7 days of death decreased healthcare costs by $451, while palliative care consultation more than 4 weeks from death decreased costs by $4,643. This study demonstrates that palliative care has the capacity to substantially reduce healthcare expenditure among advanced cancer patients. Earlier palliative care consultation results in greater cost reductions than consultation in the last week of life.
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影响因子：
45.3
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