Cost-effectiveness analysis of palliative care of cancer patients in the end of life
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | spa |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8276 |
Resumo: | Home palliative care services of terminal patients may associate home care preferences with desirable health outcomes. This study aimed to evaluate the cost-effectiveness of home palliative care of cancer patients in the last year of life in the public health subsector in a province of Argentina. A cost-effectiveness Markov model was developed from a social and the health funder’s perspective in order to reflect the reality of home palliative care at the local level compared with usual care. Direct costs to the health system and indirect costs of unpaid informal care were estimated based on local information. Palliative care increased the likelihood of patients dying at home by 10.32% compared with usual care, with annual savings of USD 750 and USD 1,012 per patient, respectively, from both the social and the funder’s perspective in the public health subsector in Río Negro. From both the social and financial perspective, the strategy to implement organized care services was more effective and lower-cost, measured by the percentage of patients who died at home. From a social perspective, the main cost inducer was the formal care provided by families, but from the funder’s perspective, it refers to the salaries of the health team. |
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Cost-effectiveness analysis of palliative care of cancer patients in the end of life Análisis de costo-efectividad de los cuidados paliativos a pacientes oncológicos de fin de vida Análise de custo-efetividade dos cuidados paliativos de pacientes oncológicos na terminalidade da vidaCuidados PaliativosCuidados Paliativos na Terminalidade da VidaAssistência DomiciliarAnálise Custo-EficiênciaCustos e Análises de CustoCuidados PaliativosCuidados Paliativos al Final de la VidaAtención Domiciliaria de SaludAnálisis Costo-EficienciaCostos y Análisis de CostoPalliative CareHospice CareHome NursingCost Efficiency AnalysisCosts and Cost AnalysisHome palliative care services of terminal patients may associate home care preferences with desirable health outcomes. This study aimed to evaluate the cost-effectiveness of home palliative care of cancer patients in the last year of life in the public health subsector in a province of Argentina. A cost-effectiveness Markov model was developed from a social and the health funder’s perspective in order to reflect the reality of home palliative care at the local level compared with usual care. Direct costs to the health system and indirect costs of unpaid informal care were estimated based on local information. Palliative care increased the likelihood of patients dying at home by 10.32% compared with usual care, with annual savings of USD 750 and USD 1,012 per patient, respectively, from both the social and the funder’s perspective in the public health subsector in Río Negro. From both the social and financial perspective, the strategy to implement organized care services was more effective and lower-cost, measured by the percentage of patients who died at home. From a social perspective, the main cost inducer was the formal care provided by families, but from the funder’s perspective, it refers to the salaries of the health team.En pacientes con enfermedad terminal, los servicios de cuidados paliativos domiciliarios pueden alinear sus preferencias de cuidado en domicilio con resultados sanitarios deseables. El objetivo fue estudiar la costo-efectividad de los cuidados paliativos domiciliarios en pacientes oncológicos en el último año de vida en el subsector público de salud de una provincia argentina. Se desarrolló un modelo de Markov de costo-efectividad desde una perspectiva social y del financiador de salud, de modo que el mismo pudiera reflejar la realidad de los cuidados paliativos domiciliarios en el ámbito local, en comparación con los cuidados habituales. Se calcularon los costos directos para el sistema de salud, con base en información local, así como también los costos indirectos de los cuidados informales no remunerados. La provisión de cuidados paliativos incrementó en un 10,32% la probabilidad que los pacientes fallezcan en el hogar, en relación con los cuidados habituales, con un ahorro anual de USD 750 y USD 1.012 por paciente desde la perspectiva social y del financiador, respectivamente, en el subsector público de salud de Río Negro. Tanto desde la perspectiva social como del financiador, la estrategia de implementación de un servicio organizado de cuidados tiene una mayor efectividad, medida en porcentaje de pacientes que fallecen en su domicilio, a un menor costo. El principal inductor de costos corresponde, desde la perspectiva social, a los cuidados informales provistos por las familias, mientras que desde la perspectiva del financiador corresponde a los salarios del personal de salud.Os serviços de cuidados paliativos domiciliares de pacientes terminais podem associar as preferências de cuidado domiciliar com resultados desejáveis de saúde. O objetivo deste texto foi avaliar a relação custo-efetividade dos cuidados paliativos domiciliares em pacientes oncológicos no último ano de vida, no subsetor de saúde pública de uma província na Argentina. Um modelo Markov de custo-efetividade foi desenvolvido a partir de uma perspectiva social e do financiador de saúde para que pudesse refletir a realidade dos cuidados paliativos domiciliares em âmbito local comparado aos cuidados habituais. Os custos diretos para o sistema de saúde e os custos indiretos de cuidados informais não remunerados foram calculados com base em informações locais. A prestação de cuidados paliativos aumentou 10,32% a probabilidade de os doentes morrerem em casa em relação com os cuidados habituais, com uma economia anual de USD 750 e USD 1.012 por paciente, respetivamente, na perspectiva social e do financiador, no subsetor da saúde pública de Rio Negro. Tanto do ponto de vista social como no financeiro, a estratégia de implantação de serviços de cuidados organizados foi mais eficaz e com menor custo, medida pelo percentual de pacientes que faleceram em casa. O principal indutor de custos corresponde, do ponto de vista social, aos cuidados informais prestados pelas famílias, enquanto do ponto de vista do financiador se refere aos salários da equipe de saúde.Reports in Public HealthCadernos de Saúde Pública2023-07-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/xmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8276Reports in Public Health; Vol. 39 No. 2 (2023): FebruaryCadernos de Saúde Pública; v. 39 n. 2 (2023): Fevereiro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZspahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8276/18486https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8276/18487Copyright (c) 2023 Cadernos de Saúde Públicainfo:eu-repo/semantics/openAccessLamfre, LauraHasdeu, SantiagoColler, MaríaTripodoro, Vilma2023-07-02T14:26:32Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8276Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:26.807771Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Cost-effectiveness analysis of palliative care of cancer patients in the end of life Análisis de costo-efectividad de los cuidados paliativos a pacientes oncológicos de fin de vida Análise de custo-efetividade dos cuidados paliativos de pacientes oncológicos na terminalidade da vida |
title |
Cost-effectiveness analysis of palliative care of cancer patients in the end of life |
spellingShingle |
Cost-effectiveness analysis of palliative care of cancer patients in the end of life Lamfre, Laura Cuidados Paliativos Cuidados Paliativos na Terminalidade da Vida Assistência Domiciliar Análise Custo-Eficiência Custos e Análises de Custo Cuidados Paliativos Cuidados Paliativos al Final de la Vida Atención Domiciliaria de Salud Análisis Costo-Eficiencia Costos y Análisis de Costo Palliative Care Hospice Care Home Nursing Cost Efficiency Analysis Costs and Cost Analysis |
title_short |
Cost-effectiveness analysis of palliative care of cancer patients in the end of life |
title_full |
Cost-effectiveness analysis of palliative care of cancer patients in the end of life |
title_fullStr |
Cost-effectiveness analysis of palliative care of cancer patients in the end of life |
title_full_unstemmed |
Cost-effectiveness analysis of palliative care of cancer patients in the end of life |
title_sort |
Cost-effectiveness analysis of palliative care of cancer patients in the end of life |
author |
Lamfre, Laura |
author_facet |
Lamfre, Laura Hasdeu, Santiago Coller, María Tripodoro, Vilma |
author_role |
author |
author2 |
Hasdeu, Santiago Coller, María Tripodoro, Vilma |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Lamfre, Laura Hasdeu, Santiago Coller, María Tripodoro, Vilma |
dc.subject.por.fl_str_mv |
Cuidados Paliativos Cuidados Paliativos na Terminalidade da Vida Assistência Domiciliar Análise Custo-Eficiência Custos e Análises de Custo Cuidados Paliativos Cuidados Paliativos al Final de la Vida Atención Domiciliaria de Salud Análisis Costo-Eficiencia Costos y Análisis de Costo Palliative Care Hospice Care Home Nursing Cost Efficiency Analysis Costs and Cost Analysis |
topic |
Cuidados Paliativos Cuidados Paliativos na Terminalidade da Vida Assistência Domiciliar Análise Custo-Eficiência Custos e Análises de Custo Cuidados Paliativos Cuidados Paliativos al Final de la Vida Atención Domiciliaria de Salud Análisis Costo-Eficiencia Costos y Análisis de Costo Palliative Care Hospice Care Home Nursing Cost Efficiency Analysis Costs and Cost Analysis |
description |
Home palliative care services of terminal patients may associate home care preferences with desirable health outcomes. This study aimed to evaluate the cost-effectiveness of home palliative care of cancer patients in the last year of life in the public health subsector in a province of Argentina. A cost-effectiveness Markov model was developed from a social and the health funder’s perspective in order to reflect the reality of home palliative care at the local level compared with usual care. Direct costs to the health system and indirect costs of unpaid informal care were estimated based on local information. Palliative care increased the likelihood of patients dying at home by 10.32% compared with usual care, with annual savings of USD 750 and USD 1,012 per patient, respectively, from both the social and the funder’s perspective in the public health subsector in Río Negro. From both the social and financial perspective, the strategy to implement organized care services was more effective and lower-cost, measured by the percentage of patients who died at home. From a social perspective, the main cost inducer was the formal care provided by families, but from the funder’s perspective, it refers to the salaries of the health team. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-07-02 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8276 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8276 |
dc.language.iso.fl_str_mv |
spa |
language |
spa |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8276/18486 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8276/18487 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Cadernos de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Cadernos de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/xml application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 39 No. 2 (2023): February Cadernos de Saúde Pública; v. 39 n. 2 (2023): Fevereiro 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
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Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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