Earlier Palliative Care Consultation Associated With Cost Savings


Key Points

  • Palliative care intervention within 6 days was associated with a 14% reduction in total direct cost.
  • Intervention within 2 days was associated with a 24% reduction.

In a prospective cohort study reported in the Journal of Clinical Oncology, May et al found that earlier palliative care consultation for inpatients with advanced cancer was associated with lower total direct costs.

Study Details

The study included 969 patients with advanced cancer admitted to 5 U.S. hospitals between 2007 and 2011, including 256 seen by a palliative care consultation team and 713 receiving usual care. Overall, palliative care patients had slightly higher total direct costs (mean = $11,150 vs $9,550; median = $7,400 vs $7,379) and longer length of stay (mean = 9 vs 8 days; median = 7 vs 6 days). The study protocol–specified palliative care consultation within 48 hours when possible; 77% of patients in the palliative care group had a consultation within this time frame.

Cost Reductions

Palliative care intervention within 6 days of hospital admission was associated with a mean reduction in total direct cost of $1,312 (14% reduction) compared with no intervention (P = .04), and intervention within 2 days was associated with a mean reduction of $2,280 (24% reduction; P = .002). Secondary analyses indicated that the cost savings were attributable to a combination of reduced length and intensity of hospital stay, with intervention being associated with reduced laboratory costs irrespective of timing and intervention within 2 days being associated with reduced length of stay and intensive care unit and pharmacy costs.

The investigators concluded: “Earlier palliative care consultation during hospital admission is associated with lower cost of hospital stay for patients admitted with an advanced cancer diagnosis. These findings are consistent with a growing body of research on quality and survival, suggesting that early palliative care should be more widely implemented.”

Peter May, MSc, of Centre for Health Policy and Management, Trinity College Dublin, is the corresponding author of the Journal of Clinical Oncology article.

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The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.