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Is home-based palliative care cost effective? An economic evaluation of the Palliative Care Extended Packages at Home (PEACH) pilot

Journal Article


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.

Authors


  •   McCaffrey, Nikki (external author)
  •   Agar, Meera (external author)
  •   Harlum, Janeane (external author)
  •   Karnon, Jonathon (external author)
  •   Currow, David C. (external author)
  •   Eckermann, Simon

Publication Date


  • 2013

Citation


  • 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.

Scopus Eid


  • 2-s2.0-84905441012

Ro Metadata Url


  • http://ro.uow.edu.au/ahsri/233

Has Global Citation Frequency


Number Of Pages


  • 4

Start Page


  • 431

End Page


  • 435

Volume


  • 3

Issue


  • 4

Place Of Publication


  • United Kingdom

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.

Authors


  •   McCaffrey, Nikki (external author)
  •   Agar, Meera (external author)
  •   Harlum, Janeane (external author)
  •   Karnon, Jonathon (external author)
  •   Currow, David C. (external author)
  •   Eckermann, Simon

Publication Date


  • 2013

Citation


  • 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.

Scopus Eid


  • 2-s2.0-84905441012

Ro Metadata Url


  • http://ro.uow.edu.au/ahsri/233

Has Global Citation Frequency


Number Of Pages


  • 4

Start Page


  • 431

End Page


  • 435

Volume


  • 3

Issue


  • 4

Place Of Publication


  • United Kingdom