Home-based Palliative Care Should be Referred More

A recent study done in Japan published in Cancer studied if there was a difference in survival time between cancer patients dying at home with palliative care compared to in hospital. The study compared adult patients with metastatic cancer who had either been admitted to palliative care, referred to hospital palliative care, or were receiving home based palliative care. Over 2000 patients were analyzed, 1000+ died in the hospital and 400+ died in home. This set of patients was then examined to see which patients lived longest based on referral date and their date of death.

The results from this study displayed a significant difference in survival rate between patients receiving hospice, and at home. The data showed that people who received palliative care at home rather than in a hospital tend to live longer, and the researchers concluded that doctor’s should not hesitate to refer home-based palliative care. Though this study only examined Japanese patients, many other countries have been publishing palliative care work that suggests in-home care provides advantages to hospital or hospice based care.

A study published in December 2015 in Palliative Medicine compared the costs of end-of-life care for lung cancer patients in America (SEER Medicare) and Canada (Ontario). Their results found  that publicly paid costs in the last 30 days of life for long-term survivors in both countries was between $10, 094 and $10, 464 US Dollars.  Importantly, in-patient hospitalization was the main cost driver with similar costs in both cohorts, suggesting that home based care may not only provide a survival benefit, but a cost benefit as well.

More recent work in this area was published in Current Oncology in February 2016, where an ARCC led team of researchers examined home nursing and hospital costs at end-of-life in three Canadian provinces (BC, ON, NS). Similar to the US/CAN study, this study suggested that increased palliative nursing costs (home based) were associated with lower relative hospital costs, and a lower total cost. This research continues to suggest there is cost-savings potential associated with increased community-based care.

ARCC continues to support investigation in the area of home-based palliative care and how it can benefit the cancer system and especially, people with cancer and their families.

To Read Further on these Articles mentioned Click the Links below:

Multi-center cohort study on the survival time of cancer patients dying at home or in a hospital: Does place matter? 

An international comparison of costs of end-of-life care for advanced lung cancer patients using Health Administrative Data

Temporal association between home nursing and hospital costs at end of life in three provinces.