TY - JOUR
T1 - The association between palliative care team consultation and hospital costs for patients with advanced cancer: An observational study in 12 Dutch hospitals
AU - Brinkman-Stoppelenburg, Arianne
AU - Polinder, Suzanne
AU - Olij, Branko F.
AU - van den Berg, Barbara
AU - Gunnink, Nicolette
AU - Hendriks, Mathijs P.
AU - van der Linden, Yvette M.
AU - Nieboer, Daan
AU - van der Padt-Pruijsten, Annemieke
AU - Peters, Liesbeth A.
AU - Roggeveen, Brenda
AU - Terheggen, Frederiek
AU - Verhage, Sylvia
AU - van der Vorst, Maurice J.
AU - Willemen, Ingrid
AU - Vergouwe, Yvonne
AU - van der Heide, Agnes
N1 - Funding Information: This study was funded by ZonMw, the Netherlands Organization for Health Research and Development (grant number 11510031) and the Erasmus Medical Center MRACE (grant number 2011‐11112), Rotterdam, the Netherlands. We thank Martin den Uijl for his assistance with the data collection. Publisher Copyright: © 2019 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - 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.
AB - 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.
KW - cancer
KW - consultation and referral
KW - costs
KW - hospital
KW - observational study
KW - palliative care
KW - palliative medicine
UR - http://www.scopus.com/inward/record.url?scp=85076379478&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/ecc.13198
DO - https://doi.org/10.1111/ecc.13198
M3 - Article
C2 - 31825156
SN - 0961-5423
VL - 29
JO - European journal of cancer care
JF - European journal of cancer care
IS - 3
M1 - e13198
ER -