Specialist palliative care has the potential to reduce costs by up to £8,000 per person and improve quality of life.
The new study, published by researchers at King’s College London in the National Institute for Health and Research (NIHR) Policy Research Unit in Palliative and End-of-Life Care, Hull York Medical School, University of Hull and University of Leeds, looked at two modes of care: for those living at home and for those in acute hospital settings.
In addition to significantly reducing the total cost of care per person, skilled palliative care provided at home and in the hospital was found to be associated with increased quality of life for patients in their final months.
In high-income countries, about 1% of people die annually, but this group accounts for 8-10% of all health spending. This high cost is largely due to unplanned hospital admissions, which can lead to fragmented and less satisfactory care. In these countries, people with serious medical illnesses largely prefer to be cared for at home if possible, but many end up dying in hospital.
This new study used economic modeling to assess the potential savings to the NHS provided by specialist palliative care. Combining the best available evidence from other surveys and government statistics, the researchers calculated the cost savings from reducing unscheduled hospital care, which is better for patients and the NHS. Quality of life was measured by assessing five dimensions of patients’ health: mobility, self-care, usual activities, pain, and anxiety or depression.
Specialist palliative care at home was associated with reduced costs of £7,908 per person who died, while specialist hospital palliative care reduced costs by £6,480 per person.
Specialist palliative care refers to care for people with more complex end-of-life needs whose care cannot be provided by a primary or basic health care team. It requires a workforce with specialist skills who are experienced in providing palliative care as their primary role.
The researchers found that in 2022 in England, specialist palliative care supported more than 20,000 people to die out of hospital, which saved around 1.5 million hospital beds and reduced healthcare spending by £817m. Many people are missing out on quality palliative care, if any at all, and there is a growing need for increased palliative care from hospices, community groups and hospitals. This new study shows the value and cost-effectiveness of specialist palliative care in helping to solve key system problems in the NHS.
Previous studies have shown that skilled palliative care helps people with serious illness stay at home. This is the first study to estimate the economic impact for England. Around half of people who could benefit from specialist palliative care do, and this is hugely cost-effective for both patients and the NHS. We must now turn our attention to understanding how and why people who might benefit are not yet receiving palliative care.”
Peter May, Lead Study Author and Senior Lecturer, Health Economics, King’s College London
Professor Fliss Murtagh at Hull York Medical School said: “Many people may be reluctant to seek palliative care, believing it may accelerate their decline and put additional pressure on the health service. The opposite is true. This study shows that good quality care in appropriate settings can improve their quality of life, reduce symptoms and other concerns and reduce medical pressure.
