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Hindi Research Article
A Retrospective, Single Center, Observational Study, Comparing the Direct Cost of End-Of-Life Care Patients with Advanced Cancer Care: Palliative Care versus Usual Care
Sinsuwan W1*, Pairojkul S1, Gomutbutra P2, Kongkum K1 and Kosuwon W31Karunrak Palliative Care Unit, Faculty of Medicine, Khon Kaen University, Thailand
2Department of Family Medicine, Faculty of Medicine, Chiangmai University, Thailand
3Department of Orthopedics, Faculty of Medicine, Khon Kaen University, Thailand
- *Corresponding Author:
- Woraporn Sinsuwan
MD, Medical Oncologist
Palliative Care Unit, Faculty of Medicine
Khon Kaen University, Khon Kaen, Thailand
Tel: +6643466655
Fax: +6643466657
E-mail: doc.mil59@gmail.com
Received date: November 23, 2015; Accepted date: January 05, 2016; Published date: January 08, 2016
Citation: Sinsuwan W, Pairojkul S, Gomutbutra P, Kongkum K, Kosuwon W (2016) A Retrospective, Single Center, Observational Study, Comparing the Direct Cost of End-Of-Life Care Patients with Advanced Cancer Care: Palliative Care versus Usual Care. J Palliat Care Med 6:243. doi:10.4172/2165-7386.1000243
Copyright: © 2016 Sinsuwan W, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Palliative care focuses on relieving and preventing the suffering of terminal ill patients. There are evidences from western countries of approved benefit of hospital palliative care consultation. They have been shown that it improves quality of care and associates with hospital cost savings. Objectives: We examined whether elected palliative care was associated with any significant cost differences for the hospital. Methods: We performed single institution (Srinagarind Hospital, Northeast Thailand), retrospective (between October 1, 2011 and September 30, 2012), observational, direct cost analysis. The sample included 52 (29.4%) hospitalized patients receiving palliative care and 125 (70.6%) under usual care. Three advanced types of cancers were included: hepatocellular carcinoma, cholangiocarcinoma and lung cancer. We adjusted cost with Diagnosis- Related Group (DRG), age, sex, length of hospital stay and comorbidity score and then compared the direct cost per admission. Results: There was no difference in the overall demographic data between the two study groups. Whilst palliative care patients with hepatocellular carcinoma undergone endotracheal intubation significantly less often (P=0.025) than usual care patients and less likely to be admitted to ICU (P=0.001). Palliative care patients with lung cancer were also most unlikely to be intubated (P<0.001) when compared to usual care patients. After adjusting for age, sex, length of hospital stay and the comorbidity scores, the adjusted net savings for the care of palliative patients was 16,669 baht per person (P=0.035) compared to usual care patients. Conclusion: The cost analysis of terminal ill patients demonstrated that hospital-based palliative care over against usual care had lower costs and utilized intensive care less.
