TY - JOUR
T1 - Exploring the costs, consequences and efficiency of three types of palliative care day services in the UK: a pragmatic before-and-after descriptive cohort study
AU - Mitchell, Paul Mark
AU - Coast, Joanna
AU - Myring, Gareth
AU - Ricciardi, Federico
AU - Vickerstaff, Victoria
AU - Jones, Louise
AU - Zafar, Shazia
AU - Cudmore, Sarah
AU - Jordan, Joanne
AU - McKibben, Laurie
AU - Graham-Wisener, Lisa
AU - Finucane, Anne
AU - Hewison, Alistair
AU - Haraldsdottir, Erna
AU - Brazil, Kevin
AU - Kernohan, George
PY - 2020/8/7
Y1 - 2020/8/7
N2 - Background: Palliative Care Day Services (PCDS) offer supportive care to people with advanced, progressive illness
who may be approaching the end of life. Despite the growth of PCDS in recent years, evidence of their costs and
effects is scarce. It is important to establish the value of such services so that health and care decision-makers can
make evidence-based resource allocation decisions. This study examines and estimates the costs and effects of
PCDS with different service configurations in three centres across the UK in England, Scotland and Northern Ireland.
Methods: People who had been referred to PCDS were recruited between June 2017 and September 2018. A
pragmatic before-and-after descriptive cohort study design analysed data on costs and outcomes. Data on costs
were collected on health and care use in the 4 weeks preceding PCDS attendance using adapted versions of the
Client Service Receipt Inventory (CSRI). Outcomes, cost per attendee/day and volunteer contribution to PCDS were
also estimated. Outcomes included quality of life (MQOL-E), health status (EQ-5D-5L) and capability wellbeing
(ICECAP-SCM).
Results: Thirty-eight attendees were recruited and provided data at baseline and 4 weeks (centre 1: n = 8; centre 2:
n = 8, centre 3: n = 22). The cost per attendee/day ranged from £121–£190 (excluding volunteer contribution) to
£172–£264 (including volunteer contribution) across the three sites. Volunteering constituted between 28 and 38%
of the total cost of PCDS provision. There was no significant mean change at 4 week follow-up from baseline for
health and care costs (centre 1: £570, centre 2: -£1127, centre 3: £65), or outcomes: MQOL-E (centre 1: − 0.48, centre
2: 0.01, centre 3: 0.24); EQ-5D-5L (centre 1: 0.05, centre 2: 0.03, centre 3: − 0.03) and ICECAP-SCM (centre 1:0.00,
centre 2: − 0.01, centre 3: 0.03). Centre costs variation is almost double per attendee when attendance rates are
held constant in scenario analysis.
AB - Background: Palliative Care Day Services (PCDS) offer supportive care to people with advanced, progressive illness
who may be approaching the end of life. Despite the growth of PCDS in recent years, evidence of their costs and
effects is scarce. It is important to establish the value of such services so that health and care decision-makers can
make evidence-based resource allocation decisions. This study examines and estimates the costs and effects of
PCDS with different service configurations in three centres across the UK in England, Scotland and Northern Ireland.
Methods: People who had been referred to PCDS were recruited between June 2017 and September 2018. A
pragmatic before-and-after descriptive cohort study design analysed data on costs and outcomes. Data on costs
were collected on health and care use in the 4 weeks preceding PCDS attendance using adapted versions of the
Client Service Receipt Inventory (CSRI). Outcomes, cost per attendee/day and volunteer contribution to PCDS were
also estimated. Outcomes included quality of life (MQOL-E), health status (EQ-5D-5L) and capability wellbeing
(ICECAP-SCM).
Results: Thirty-eight attendees were recruited and provided data at baseline and 4 weeks (centre 1: n = 8; centre 2:
n = 8, centre 3: n = 22). The cost per attendee/day ranged from £121–£190 (excluding volunteer contribution) to
£172–£264 (including volunteer contribution) across the three sites. Volunteering constituted between 28 and 38%
of the total cost of PCDS provision. There was no significant mean change at 4 week follow-up from baseline for
health and care costs (centre 1: £570, centre 2: -£1127, centre 3: £65), or outcomes: MQOL-E (centre 1: − 0.48, centre
2: 0.01, centre 3: 0.24); EQ-5D-5L (centre 1: 0.05, centre 2: 0.03, centre 3: − 0.03) and ICECAP-SCM (centre 1:0.00,
centre 2: − 0.01, centre 3: 0.03). Centre costs variation is almost double per attendee when attendance rates are
held constant in scenario analysis.
U2 - 10.1186/s12904-020-00624-y
DO - 10.1186/s12904-020-00624-y
M3 - Article
VL - 19
JO - BMC palliative care
JF - BMC palliative care
SN - 1472-684X
M1 - 119
ER -