Early Palliative Care for Cancer Patients With More Comorbidities Reduces Cost

Providing cancer patients with multiple life-threatening conditions with earlier palliative care consultation can be helpful in bringing down healthcare spending in enormous proportions, according to a new study published in Health Affairs.

With almost 40% of Americans falling prey to cancer in their lifetime, improving care for cancer patients has become a top priority for US healthcare. Cancer patients are also prone to multiple comorbidities, which accounts for a high proportion of healthcare-related spending.

The new study conducted by Peter May, MSc, along with his fellow researchers finds that the impact of palliative care consultation is tremendous in reducing hospital costs for patients with advanced cancer.

Scope of the Study

The data used to evaluate the effect of palliative care on patients with an advanced cancer diagnosis was collected for the period of 2007 to 2011. Patients from 6 hospitals—2 tertiary care academic medical centers, 1 specialty cancer center, and 3 community teaching hospitals—were recruited for the research.

The study, approved by each facility’s Institutional Review Board, deliberately obtained data from a geographically diverse group representing different ethnic and socioeconomic populations. All participants were above 18 years of age and suffered from advanced cancer. Patients who had dementia or who had previously received a hospital palliative care consultation were excluded from the study.

Results

The study included 906 patients with advanced cancer and comorbidities. Out of the total, 192 patients received palliative care within 2 days of admission. When patients received consultation from a palliative care team within 2 days of admission, the total direct hospital costs for advanced cancer patients with comorbidities were significantly reduced. This reduction in cost grew larger as the number of comorbidities increased.

For patients with a comorbidity score of 0-1, the estimated reduction in cost was not significant. However, for patients with a score of 2-3, the estimated reduction in cost was 22% (approximately $2321). Furthermore, for patients with a score of 4 or higher, the reduction was 32% (approximately $3515).

The study also demonstrated a systematic and consistent relationship between the timing of consultation and its effect on cost. If patients received earlier consultation, the effect on the reduction of costs was robust. The earlier the intervention, the larger the effect on hospital cost reduction.

Conclusion

The study highlights some important implications in the policy context of care for patients with advanced cancer and comorbidities.

Compared to usual care, patients who received palliative care consultation early on brought down hospital costs in significant proportions. The results were stronger and more consistent with patients suffering from advanced cancer with higher comorbidity scores.

If the healthcare industry targets early specialist palliative care to hospitalized patients with advanced cancer and higher numbers of serious concurrent conditions, the results will be 2-fold: patients will receive improved care and the health care spending will reduce drastically.