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. 2017 Apr;31(4):323-337.
doi: 10.1177/0269216316670287. Epub 2016 Sep 27.

What cost components are relevant for economic evaluations of palliative care, and what approaches are used to measure these costs? A systematic review

Clare Gardiner  1 , Christine Ingleton  1 , Tony Ryan  1 , Sue Ward  2 , Merryn Gott  3
Affiliations

What cost components are relevant for economic evaluations of palliative care, and what approaches are used to measure these costs? A systematic review

Clare Gardiner et al. Palliat Med. 2017 Apr.

Abstract

Background: It is important to understand the costs of palliative and end-of-life care in order to inform decisions regarding cost allocation. However, economic research in palliative care is very limited and little is known about the range and extent of the costs that are involved in palliative care provision.

Aim: To undertake a systematic review of the health and social care literature to determine the range of financial costs related to a palliative care approach and explore approaches used to measure these costs.

Design: A systematic review of empirical literature with thematic synthesis. Study quality was evaluated using the Weight of Evidence Framework.

Data sources: The databases CINAHL, Cochrane, PsycINFO and Medline were searched from 1995 to November 2015 for empirical studies which presented data on the financial costs associated with palliative care.

Results: A total of 38 papers met our inclusion criteria. Components of palliative care costs were incurred within four broad domains: hospital care, community or home-based care, hospice care and informal care. These costs could be considered from the economic viewpoint of three providers: state or government, insurers/third-party/not-for-profit organisations and patient and family and/or society. A wide variety of costing approaches were used to derive costs.

Conclusion: The evidence base regarding the economics of palliative care is sparse, particularly relating to the full economic costs of palliative care. Our review provides a framework for considering these costs from a variety of economic viewpoints; however, further research is required to develop and refine methodologies.

Keywords: Palliative care; costs and cost analysis; economic evaluation; end-of-life care; health expenditure; healthcare costs; systematic review.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA diagram summarising search results.
See this image and copyright information in PMC

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