Abstract

Despite the numerous benefits of palliative care for cancer patients, there have been few studies on palliative care services for terminal cancer patients, particularly near the end of life. This study aimed to evaluate whether there were differences in length of stay and cost of care associated with how early or late a patient received palliative care intervention. Another objective was to compare the length of stay and cost of care of those who received palliative care intervention and those who did not. This study used a cohort retrospective design at Hospital A, Jakarta, Indonesia, from January to December 2019. The diagnosis of terminal cancer was based on medical records. Data on length of stay and costs of care were based on medical records and finance billing. The hospitalized terminal cancer patients (392) were recruited by consecutive sampling. The length of stay and costs of care for patients with advanced cancer who received palliative care consultations were longer and higher than for patients who did not receive them. However, if palliative care consultation is provided early, the increase in length of stay and costs are less.

References

1. Radbruch L, De Lima L, Knaul F, et al. Redefining Palliative Care-A New Consensus-Based Definition. J Pain Symptom Manage. 2020; 60 (4): 754-764. DOI: 10.1016/j.jpainsymman.2020.04.027

2. World Health Organization. Planning and implementing palliative care services: A guide for programme managers. Geneva: World Health Organization; 2016.

3. Minnaar CA, Szasz A, Lee SY, et al. Supportive and Palliative Care in Cancer Therapies—Path from Tumor-Driven Therapies to PatientDriven Ones. Int J Clin Med. 2022; 13 (7): 287-359. DOI: 10.4236/ijcm.2022.137024

4. Bajwah S, Oluyase AO, Yi D, et al. The effectiveness and costeffectiveness of hospital-based specialist palliative care for adults with advanced illness and their caregivers. Cochrane Database Syst Rev. 2020; 9 (9): CD012780. DOI: 10.1002/14651858.CD012780.pub2

5. Calvache JA, Gil F, De Vries E. How many people need palliative care for cancer and non-cancer diseases in a middle-income country? Analysis of mortality data. Rev Colomb Anestesiol. 2020; 48 (4). DOI: 10.1097/cj9.0000000000000159

6. ACTION Study Group. Catastrophic health expenditure and 12-month mortality associated with cancer in Southeast Asia: Results from a longitudinal study in eight countries. BMC Med. 2015; 13: 190. DOI: 10.1186/s12916-015-0433-1

7. Subramaniam DS, Al-Hammadi N, Jenkins A, Hinyard LJ. Association between palliative care consultation, hospital length of stay, and inhospital costs in women with metastatic breast cancer in United States. J Clin Oncol. 2022; 40 (16 Suppl): e24068. DOI: 10.1200/JCO.2022.40.16_suppl.e24068

8. Zhuang H, Ma Y, Wang L, Zhang H. Effect of early palliative care on quality of life in patients with non-small-cell lung cancer. Curr Oncol. 2018; 25 (1): e54-e58. DOI: 10.3747/co.25.3639

9. Brinkman-Stoppelenburg A, Polinder S, Olij BF, et al. The association between palliative care team consultation and hospital costs for patients with advanced cancer: An observational study in 12 Dutch hospitals. Eur J Cancer Care (Engl). 2020; 29 (3): e13198. DOI: 10.1111/ecc.13198

10. Robinson J, Gott M, Gardiner C, Ingleton C. The 'problematisation' of palliative care in hospital: An exploratory review of international palliative care policy in five countries. BMC Palliat Care. 2016; 15: 64. DOI: 10.1186/s12904-016-0137-0

11. Setia MS. Methodology Series Module 1: Cohort Studies. Indian J Dermatol. 2016; 61 (1): 21-25. DOI: 10.4103/0019-5154.174011

12. Sedgwick P. Retrospective cohort studies: Advantages and disadvantages. BMJ. 2014; 348: g1072. DOI: 10.1136/bmj.g1072

13. Johnston KM, Lakzadeh P, Donato BMK, et al. Methods of sample size calculation in descriptive retrospective burden of illness studies. BMC Med Res Methodol. 2019; 19: 9. DOI: 10.1186/s12874-018- 0657-9

14. Pourhoseingholi MA, Vahedi M, Rahimzadeh M. Sample size calculation in medical studies. Gastroenterol Hepatol Bed Bench. 2013; 6 (1): 14-7.

15. World Health Organization. Cancer. Geneva: World Health Organization; 2022.

16. Australian Institute of Health and Welfare. Palliative care services in Australia. Canberra: Australian Institute of Health and Welfare; 2023.

17. May P, Garrido MM, Cassel JB, et al. Prospective Cohort Study of Hospital Palliative Care Teams for Inpatients with Advanced Cancer: Earlier Consultation Is Associated With Larger Cost-Saving Effect. J Clin Oncol. 2015; 33 (25): 2745-52. DOI: 10.1200/JCO.2014.60.2334

18. Fitzpatrick J, Mavissakalian M, Luciani T, et al. Economic Impact of Early Inpatient Palliative Care Intervention in a Community Hospital Setting. J Palliat Med. 2018; 21 (7): 933-939. DOI: 10.1089/jpm.2017.0416

19. Oncology Nursing Society. Palliative Care for People with Cancer. Pittsburgh, PA: Oncology Nursing Society; 2014.

20. Haun MW, Estel S, Rücker G, et al. Early palliative care for adults with advanced cancer. Cochrane Database Syst Rev. 2017; 6 (6):CD011129. DOI: 10.1002/14651858.CD011129.pub2

21. Zaborowski N, Scheu A, Glowacki N, et al. Early Palliative Care Consults Reduce Patients' Length of Stay and Overall Hospital Costs. Am J Hosp Palliat Care. 2022; 39 (11): 1268-1273. DOI: 10.1177/10499091211067811

22. Chanthong P, Punlee K, Kowkachaporn P, et al. Comparison of direct medical care costs between patients receiving care in a designated palliative care unit and the usual care units. Asia Pac J Clin Oncol. 2023; 19 (4): 493-498. DOI: 10.1111/ajco.13882

23. Witjaksono MA, Effendy C, Mulatsih S, et al. Criteria for Palliative Care Referral in Oncology Practice: An Instrument Development. Bali Med J. 2021; 10 (1): 281-290. DOI: 10.15562/bmj.v10i1.2120

24. Efendy C, Silva JFDS, Padmawati RS. Correction to: Identifying palliative care needs of patients with non-communicable diseases in Indonesia using the SPICT tool: A descriptive cross-sectional study. BMC Palliat Care. 2022; 21 (1): 19. DOI: 10.1186/s12904-022- 00909-4

25. Putranto R, Agung RA, Irawan C, et al. Palliative Screening Tools to Identify Palliative Care Consultation at Tertiary Hospital. Acta Med Indonesiana. 2022; 54 (1): 28-34.

26. Jha AK. End-of-Life Care, Not End-of-Life Spending. JAMA. 2018; 320 (7): 631-632. DOI: 10.1001/jama.2018.11177

Download

Share

COinS