Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Costs of palliative care for cancer patients in the public acute healthcare setting: results from a Queensland population data linkage study (COS-Q) (#104)

Katharina MD Merollini 1 2 , Louisa Gordon 3 4 5 , Joanne Aitken 6 7 8 , Michael Kimlin 9 10
  1. University of the Sunshine Coast, Sippy Downs, Queensland, Australia
  2. Sunshine Coast Health Institute, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  3. Health Economics, QIMR Berghofer Research Institute, Herston, Queensland, Australia
  4. Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
  5. School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
  6. Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
  7. School of Public Health, University of Queensland, Herston, Queensland, Australia
  8. School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
  9. Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
  10. Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia

Aim: The aim of this research was to quantify palliative care costs of cancer patients in the public acute care setting in Queensland, Australia.

Methods: The study cohort comprised population-level data of Queensland residents, diagnosed with a first primary malignancy between 1997 and 2015 who underwent palliative care in a public acute hospital setting between July 2012- December 2016. Administrative databases were linked with cancer registry records to capture health service utilization. Health service costs were analysed using a bottom-up costing approach on a cohort as well as patient-level.

Results: A total of N=17,012 individuals with a history of cancer underwent palliative care in a public acute setting during the study period, of which 94.7% received palliative care due to cancer and 76% died in hospital. Total expenditure on a cohort level over 4.5yrs was AU$262.6 million with highest total palliative care costs for lung (AU$49 m), colorectal (AU$31.5 m) and prostate cancer (AU$27.8m). Highest mean cost per person were incurred by individuals with a history of brain (AU$21,950, SD 23,370) and cervical cancer (AU$19,424, SD 22,629). Palliative care costs were the highest for younger age groups 0-24yrs (AU$20,951 mean total cost, SD 29,150) and steadily decreased with age (lowest for 90yrs+ (AU$12,293, SD 14,291). Individuals accessing palliative services in major cities and inner regional areas had lower mean costs and shorter LoS (AU$14,800, LoS: 8.3 days) compared to patients in outer regional (AU$18,000, LoS: 11.1 days), remote (AU$22,350, LoS: 13.2 days) and very remote areas (AU$28,000, LoS: 14.3 days).

Conclusions: Palliative care was accessed by around ~4,000 cancer patients/year. More research is needed to determine causality of factors contributing to a high economic burden. This research may support future programs and investments in end-of-life care to optimise patient outcomes and to reduce the economic burden.