Evidence map›Paper›PMID 29216873›Full record

ArticleBMC palliative care2017

Community-based specialist palliative care is associated with reduced hospital costs for people with non-cancer conditions during the last year of life.

Katrina Spilsbury, Lorna Rosenwax

Abstract read
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In one paragraph

Article in BMC palliative care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  9. Quality of end-of-life care with non-malignant liver disease: Analysis of the VOICES National Survey of Bereaved People.Liver international : official journal of the International Association for the Study of the Liver · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Katrina SpilsburyCentre for Population Health Research, Faculty of Health Sciences, Curtin University, Perth, Australia.ORCID http://orcid.org/0000-0002-7434-2957
Lorna RosenwaxSchool of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, 6845, Australia. L.Rosenwax@curtin.edu.au.

Funding

National Health and Medical Research Council 1029663
6 · The paper itself

Abstract

backgroundCommunity-based palliative care is associated with reduced hospital costs for people dying from cancer. It is unknown if reduced hospital costs are universal across multiple life-limiting conditions amenable to palliative care. The aim of this study was to determine if community-based palliative care provided to people dying from non-cancer conditions was associated with reduced hospital costs in the last year of life and how this compared with people dying from cancer.

methodA retrospective population-based cohort study of all decedents in Western Australia who died January 2009 to December 2010 from a life-limiting condition considered amenable to palliative care. Hospital costs were assigned to each day of the last year of life for each decedent with a zero cost applied to days not in hospital. Day-specific hospital costs averaged over all decedents (cohort averaged) and decedents in hospital only (inpatient averaged) were estimated. Two-part models and generalised linear models were used.

resultsThe cohort comprised 12,764 decedents who, combined, spent 451,236 (9.7%) days of the last year of life in hospital. Overall, periods of time receiving community-based specialist palliative care were associated with a 27% decrease from A$112 (A$110-A$114) per decedent per day to $A82 (A$78-A$85) per decedent per day of CA hospital costs. Community-based specialist palliative care was also associated a reduction of inpatient averaged hospital costs of 9% (7%-10%) to A$1030 per hospitalised decedent per day. Hospital cost reductions were observed for decedents with organ failures, chronic obstructive pulmonary disease, Alzheimer's disease, Parkinson's disease and cancer but not for motor neurone disease. Cost reductions associated with community-based specialist palliative care were evident 4 months before death for decedents with cancer and by one to 2 months before death for decedents dying from other conditions.

conclusionCommunity-based specialist palliative care was associated with hospital cost reductions across multiple life-limiting conditions.

Indexed as

AgedAged, 80 and overAlzheimer DiseaseCohort StudiesCosts and Cost AnalysisFemaleHeart FailureHospital CostsHumansLiver FailureMaleMiddle AgedPalliative CareParkinson DiseasePublic HealthPulmonary Disease, Chronic ObstructiveAlzheimer’s diseaseCancerChronic obstructive pulmonary diseaseHeart failureHospital costsLiver failurePalliative careParkinson’s diseaseRenal failure

Identifiers

PMID29216873
PMCPMC5721619

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.