World Health Matters: Ireland: Early palliative care delivers cost savings

by Gary Finnegan: People with terminal cancer often require palliative care in the late stages of their lives. This branch of medicine has long been lauded for the compassion and humanity it provides to patients and their families during a difficult time.

However, new research provides the first strong evidence that there may also be significant economic benefits to embracing palliative care.

A study led by researchers at Trinity College Dublin in collaboration with doctors at Mount Sinai in New York shows that early access to expert palliative care 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.

Published in the Journal of Clinical Oncology, the paper draws on a study of over 1,000 patients’ pathways to care in five major US hospitals. Peter May, an expert in the economics of cancer at Trinity College, led a team which looked at the costs associated with their care based on whether patients saw a specialist palliative care consultation team or received standard hospital care.

In this study the specialist palliative care consultation was conducted with a specialist-led interdisciplinary team that treated pain and other symptoms, clarified treatment options, established goals of care and advance plans, and helped patients and family members select treatments.

The researchers found that in patients with advanced stage cancer, 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.

“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 ageing population and changing patterns of disease,” says May.

He adds that access to palliative care services should be improved not just for patients at the end of life but also for those living with serious illness. Developing further evidence of the range of benefits palliative medicine can bring is essential to influencing policy in this area.

“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,” May says.