Implementing earlier expert palliative care decision making and treatment results in significantly lower costs

Researchers at Trinity College Dublin and Mount Sinai in New York have just published new research which for the first time provides strong evidence on the economic benefits of early palliative care intervention for people with an advanced cancer diagnosis. Their findings were published today in the highly esteemed international peer reviewed Journal of Clinical Oncology.

Previous research has shown the clinical benefits of early palliative care, but this new study robustly demonstrated how early access to expert palliative care decision making resulted in very significant cost reductions of up to 24%. The intervention reduced both the length and intensity of hospital stay for patients with advanced cancer.

The researchers from Trinity's Centre for Health Policy and Management and Mount Sinai's Icahn School of Medicine, led by Peter May, HRB Economics of Cancer Fellow at Trinity, studied over 1000 patients' pathways of care in five major US hospitals and looked at costs associated with their care based on whether they saw a specialist palliative care consultation team or received standard hospital care.

They found that an intervention within six days was estimated to reduce costs by 14% compared to no intervention, and an intervention within two days led to a 24% reduction in cost of hospital stay.

Lead author of the study, Peter May from Trinity said: "Despite the known clinical benefits of earlier palliative care, there was little evidence on the association between treatment timing and economic benefits. Our findings show that alongside proven clinical benefits and outcomes for patients and their families there are also cost savings for the health system; a very important consideration in the context of an aging population and changing patterns of disease."

"It is also important to recognise that palliative care is not only for patients at end of life but can have substantial benefits for many patients living with serious illness. We will now look to apply our research findings to the Irish setting. Across Ireland there are excellent palliative care services for people living and dying with serious illness but there remains a high level of unmet need. High quality research is essential to improving understanding of the potential benefits of palliative care for patients and their families, and for the wider health system."

In this study the specialist palliative care consultation was conducted with a specialist-led interdisciplinary team that assists in the treatment of seriously ill patients through identification and treatment of pain and other symptoms, clarifying treatment options, establishing goals of care and advance plans, and helping patients and family members select treatments that match their goals.

Usual care comprised each individual hospital and service approach to routine assessment of pain and other symptoms, function, nutrition, sleep and emotional concerns.