A multi-province study has found that investment in home-based palliative care reduces overall costs to the health-care system. The findings were published in a special issue of Current Oncology.
In collaboration with researchers from Ontario’s Institute for Clinical Evaluative Sciences and the Centre for Health Services and Policy Research in British Columbia, Dalhousie Medical School researchers Dr. Fred Burge and Beverley Lawson looked at patterns of health care among almost 60,000 cancer patients in Nova Scotia, Ontario and British Columbia during their last six months of life.
“Our data indicate that when people receive more nursing care at home, in the four weeks prior to death, they’re less likely to visit the hospital,” says Dr. Burge, professor and director of research in the Department of Family Medicine. “So overall, the health-care system spends less money for these patients than for those who rely on hospital care only.”
Examining cost differences
The average total savings for each patient receiving home-based palliative nursing care ranged from several hundred dollars to a little over a thousand dollars.
“While that might seem relatively modest, imagine these savings being magnified across the system, across multiple provinces,” says Dr. Burge.
“Previous studies examining home-based care versus hospital-based care have generally not examined cost differences — and the few that have only looked within a single health system. We looked at several jurisdictions, and our findings were consistent across all three provinces.”
As part of another study conducted in Nova Scotia, the Department of Family Medicine found that the vast majority of people with advanced chronic disease — 84 per cent — wanted to die out of hospital. And most (74 per cent) voiced a preference to die at home.
“As we examine health-care reform and new approaches to caring for the dying in Canada, our study shows that not only can an increased investment in home-based care better meet patient preferences, it can also lead to cost savings across the system — either by reducing expensive hospitalizations or by avoiding them altogether," says Dr. Burge.
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