Cost-utility analysis of palliative care in patients with advanced cancer: a retrospective study

Abstract Background Aging population and other factors have led to a rapid rise in cancer incidence in China. However, under the influence of traditional perception of diseases, deaths and economic factors, many patients who are unresponsive to radical treatment are still adherent to excessive and u...

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Main Authors: Hao Wu, Ping Lin, Shujuan Yang, Wei Zhang, Wenjuan Tao
Format: Article
Language:English
Published: BMC 2021-08-01
Series:BMC Palliative Care
Subjects:
QoL
Online Access:https://doi.org/10.1186/s12904-021-00816-0
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spelling doaj-78cf92fe7bbd4905a1020e9cf14dffda2021-08-15T11:12:33ZengBMCBMC Palliative Care1472-684X2021-08-0120111110.1186/s12904-021-00816-0Cost-utility analysis of palliative care in patients with advanced cancer: a retrospective studyHao Wu0Ping Lin1Shujuan Yang2Wei Zhang3Wenjuan Tao4Institute of Hospital Management, West China Hospital, Sichuan UniversityWest China School of Public Health and West China Fourth Hospital, Sichuan UniversityWest China School of Public Health and West China Fourth Hospital, Sichuan UniversityInstitute of Hospital Management, West China Hospital, Sichuan UniversityInstitute of Hospital Management, West China Hospital, Sichuan UniversityAbstract Background Aging population and other factors have led to a rapid rise in cancer incidence in China. However, under the influence of traditional perception of diseases, deaths and economic factors, many patients who are unresponsive to radical treatment are still adherent to excessive and unnecessary treatment, which may lead to poor quality of life (QoL) and increase unnecessary medical burden. Aim Compare the difference of the quality of life and cost-utility value between patients who received palliative care (PC) and patients who were adherent to conventional anticancer treatment (CAT) and provides empirical evidence of clinical and economic value for hospital-based PC. Methods Chinese Quality of Life Questionnaire (CQLQ) Scale was used to collect advanced cancer patients’ QoL on admission and discharge days. Paired and independent samples’ statistical analysis were used to compare inter- and intra- QoL between PC and CAT group. Delphi and Analytic Hierarchy Process were used to weight QoL scores and converted the QoL to quality-adjusted life years (QALYs). Propensity Score Matching (PSM) for 1:1 was used to compare average hospitalization expenses between two groups. The expense per QALYs was used for Cost-Utility analysis between the two treatments. Results A total of 248 hospitalized patients diagnosed with metastatic disease at stage IV were recruited from West China Fourth Hospital between January 2018 and August 2018, including 128 patients receiving PC and 120 patients receiving CAT. Although both treatments had positive effects on improving QoL for patients, the QoL in the PC group were significantly higher than that in the CAT group (55.90 ± 18.80 vs 24.00 ± 8.60, t = 7.51, p < 0.05). The QALY (days) of pre- and post- treatment increased by 55.9 and 24.0 days in PC and CAT group respectively. Compared average hospitalization expense in 613 pairs of advanced cancer inpatients after PSM 1:1, the per capita expense of PC group was higher (13,743.5 ± 11,574.1 vs 11,689.0 ± 8876.8, t = 3.44, p < 0.05), while each unit of QALYs paid by PC group was only 50% of that paid by those receiving CAT. Conclusions PC played a positive role in improving the QoL for patients diagnosed with advanced cancer and alleviating economic burdens of both patient families and the society from the viewpoint of cost-utility. Our findings imply that PC should be recognized as a proactive care model in China that helps patients with some terminal diseases.https://doi.org/10.1186/s12904-021-00816-0Palliative CareConventional Anticancer TreatmentsQoLQALYsCost-Utility Analysis
collection DOAJ
language English
format Article
sources DOAJ
author Hao Wu
Ping Lin
Shujuan Yang
Wei Zhang
Wenjuan Tao
spellingShingle Hao Wu
Ping Lin
Shujuan Yang
Wei Zhang
Wenjuan Tao
Cost-utility analysis of palliative care in patients with advanced cancer: a retrospective study
BMC Palliative Care
Palliative Care
Conventional Anticancer Treatments
QoL
QALYs
Cost-Utility Analysis
author_facet Hao Wu
Ping Lin
Shujuan Yang
Wei Zhang
Wenjuan Tao
author_sort Hao Wu
title Cost-utility analysis of palliative care in patients with advanced cancer: a retrospective study
title_short Cost-utility analysis of palliative care in patients with advanced cancer: a retrospective study
title_full Cost-utility analysis of palliative care in patients with advanced cancer: a retrospective study
title_fullStr Cost-utility analysis of palliative care in patients with advanced cancer: a retrospective study
title_full_unstemmed Cost-utility analysis of palliative care in patients with advanced cancer: a retrospective study
title_sort cost-utility analysis of palliative care in patients with advanced cancer: a retrospective study
publisher BMC
series BMC Palliative Care
issn 1472-684X
publishDate 2021-08-01
description Abstract Background Aging population and other factors have led to a rapid rise in cancer incidence in China. However, under the influence of traditional perception of diseases, deaths and economic factors, many patients who are unresponsive to radical treatment are still adherent to excessive and unnecessary treatment, which may lead to poor quality of life (QoL) and increase unnecessary medical burden. Aim Compare the difference of the quality of life and cost-utility value between patients who received palliative care (PC) and patients who were adherent to conventional anticancer treatment (CAT) and provides empirical evidence of clinical and economic value for hospital-based PC. Methods Chinese Quality of Life Questionnaire (CQLQ) Scale was used to collect advanced cancer patients’ QoL on admission and discharge days. Paired and independent samples’ statistical analysis were used to compare inter- and intra- QoL between PC and CAT group. Delphi and Analytic Hierarchy Process were used to weight QoL scores and converted the QoL to quality-adjusted life years (QALYs). Propensity Score Matching (PSM) for 1:1 was used to compare average hospitalization expenses between two groups. The expense per QALYs was used for Cost-Utility analysis between the two treatments. Results A total of 248 hospitalized patients diagnosed with metastatic disease at stage IV were recruited from West China Fourth Hospital between January 2018 and August 2018, including 128 patients receiving PC and 120 patients receiving CAT. Although both treatments had positive effects on improving QoL for patients, the QoL in the PC group were significantly higher than that in the CAT group (55.90 ± 18.80 vs 24.00 ± 8.60, t = 7.51, p < 0.05). The QALY (days) of pre- and post- treatment increased by 55.9 and 24.0 days in PC and CAT group respectively. Compared average hospitalization expense in 613 pairs of advanced cancer inpatients after PSM 1:1, the per capita expense of PC group was higher (13,743.5 ± 11,574.1 vs 11,689.0 ± 8876.8, t = 3.44, p < 0.05), while each unit of QALYs paid by PC group was only 50% of that paid by those receiving CAT. Conclusions PC played a positive role in improving the QoL for patients diagnosed with advanced cancer and alleviating economic burdens of both patient families and the society from the viewpoint of cost-utility. Our findings imply that PC should be recognized as a proactive care model in China that helps patients with some terminal diseases.
topic Palliative Care
Conventional Anticancer Treatments
QoL
QALYs
Cost-Utility Analysis
url https://doi.org/10.1186/s12904-021-00816-0
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