Analysis of health care costs for patients with cancer at the end of life: Hospital versus home with palliative care, at the third level of care

• Autores: Amado-Tineo, José Percy, Che-Hidalgo, Elizabeth, Apolaya-Segura, Moisés, Castillo-Cáceres, Diana, Vásquez-Alva, Rolando, Huari-Pastrana, Roberto, Taype-Huamaní, Waldo, Oscanoa-Espinoza, Teodoro
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
• Repositorio: Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
• Lenguaje: español
• OAI Identifier: oai:cmhnaaa_ojs_cmhnaaa.cmhnaaa.org.pe:article/1071
• Enlace del recurso: https://cmhnaaa.org.pe/ojs/index.php/rcmhnaaa/article/view/1071
• Nivel de acceso: acceso abierto
• Materia: Costos y análisis de costo; Atención médica; Etapa final de vida; Enfermedad oncológica; Costs and cost analysis; Medical care; Terminal stage of illness; Death

Background: The final stage of cancer patients generates high costs, especially in hospitals. Objectives: To determine the difference in care costs at the end of life for cancer patients in the hospital versus at home. Material and methods: Retrospective cost analysis study in patients who died of clinical stage IV cancer in a tertiary social security hospital, March 2018. A home group (Home) of a palliative program was compared with a hospital group (Hospital) admitted from the emergency department. Direct costs of professional services, hospitalization, procedures, auxiliary exams, and medications were estimated. Chi square and Student's T were used for statistical analysis, considering a value of p<0.05 and using SPSS 24.0. Results: 81 patients in Home and 22 in Hospital were included, aged between 36 and 96 years, with a median of 72 years in Home and 77 in Hospital (p=0.97), female sex 59 and 73% respectively (p= 0.25), predominantly cancer of digestive and genitourinary origin. The average cost per patient in Home was 497 US dollars and in Hospital 1908 (p<0.01), with a daily average per patient of 17 vs 447 respectively. In the Hospital, the costs of hospitalization, auxiliary tests (tomography, resonance, arterial gas analysis, C-reactive protein) and antibiotics (ertapenem and colistin) predominated, while in the Home the highest cost was in medical services and medications. Conclusion: The medical costs in the final stage of life of patients with advanced cancer are 3.8 times higher when they die in the hospital than at home.