title: Resource consumption and costs of palliative care services in Spain: a multicenter prospective study.
abstract: Patients (n=395) with terminal-stage cancer receiving attention from palliative care services (PCSs) were recruited over a period of 15 consecutive days from 171 participating PCS units. Resource consumption and costs were evaluated for 16 weeks of follow-up, and the findings were compared with a study conducted in 1992 so as to assess change over time. The most frequent health care interventions were homecare visits, hospital admissions, and patient-consultant phone calls. PCS provided 67% of all services and consultation interventions in 91% of patients. Compared with the historical data, there was a significant shift from the use of conventional hospital beds toward palliative care beds, a reduced hospital stay (25.5-19.2 days; P=0.002), an increase in the death-at-home option (31%-42%), a lower use of hospital emergency rooms (52%-30.6%; P=0.001), and an increase in programmed care. Compared to the previous resource consumption and expenditure study in 1992, the current PCS policy implies a cost saving of 61%, with greater efficiency and no compromise of patient care.
authors.affiliation: Palliative Care Service (X.G.-B., A.T., E.C., J.P.-S., J.E.), and Cancer Epidemiology Unit (X.C.), Institut Català d'Oncologia, Barcelona, Spain. xgomez@ico.scs.es
authors.forename: Xavier
authors.initials: X
authors.lastname: Gómez-Batiste
authors.forename: Albert
authors.initials: A
authors.lastname: Tuca
authors.forename: Esther
authors.initials: E
authors.lastname: Corrales
authors.forename: Josep
authors.initials: J
authors.lastname: Porta-Sales
authors.forename: Maria
authors.initials: M
authors.lastname: Amor
authors.forename: José
authors.initials: J
authors.lastname: Espinosa
authors.forename: Josep M A
authors.initials: JM
authors.lastname: Borràs
authors.forename: Isabel
authors.initials: I
authors.lastname: de la Mata
authors.forename: Xavier
authors.initials: X
authors.lastname: Castellsagué
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000628:therapy; D010166:Palliative Care / Q000191:economics*; D013030:Spain