Is home-based palliative care cost-effective? An economic evaluation of the palliative care extended packages at home (PEACH) pilot

McCaffrey, N; Agar, M; Harlum, J; Karnon, J; Currow, D; Eckermann, S

Is home-based palliative care cost-effective? An economic evaluation of the palliative care extended packages at home (PEACH) pilot

McCaffrey, N Agar, M

Harlum, J Karnon, J Currow, D

Eckermann, S

Permalink

Publication Type:: Journal Article
Citation:: BMJ Supportive and Palliative Care, 2013, 3 (4), pp. 431 - 435
Issue Date:: 2013-01-01

Closed Access

	Filename	Description	Size
	431.full.pdf	Published Version	173.87 kB	Adobe PDF	View/Open

Copyright Clearance Process

Recently Added
In Progress
Closed Access

This item is closed access and not available.

Full metadata record

Field	Value	Language
dc.contributor.author	McCaffrey, N	en_US
dc.contributor.author	Agar, M https://orcid.org/0000-0002-6756-6119	en_US
dc.contributor.author	Harlum, J	en_US
dc.contributor.author	Karnon, J	en_US
dc.contributor.author	Currow, D https://orcid.org/0000-0003-1988-1250	en_US
dc.contributor.author	Eckermann, S	en_US
dc.date.issued	2013-01-01	en_US
dc.identifier.citation	BMJ Supportive and Palliative Care, 2013, 3 (4), pp. 431 - 435	en_US
dc.identifier.issn	2045-435X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/115776
dc.description.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 followup and comprehensive economic evaluation.	en_US
dc.relation.ispartof	BMJ Supportive and Palliative Care	en_US
dc.relation.isbasedon	10.1136/bmjspcare-2012-000361	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Chronic Disease	en_US
dc.subject.mesh	Patient Admission	en_US
dc.subject.mesh	Palliative Care	en_US
dc.subject.mesh	Case-Control Studies	en_US
dc.subject.mesh	Pilot Projects	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Home Care Services	en_US
dc.subject.mesh	Cost-Benefit Analysis	en_US
dc.subject.mesh	State Medicine	en_US
dc.subject.mesh	England	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Is home-based palliative care cost-effective? An economic evaluation of the palliative care extended packages at home (PEACH) pilot	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	3	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	3	en_US

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 followup and comprehensive economic evaluation.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/115776