OBJECTIVES

Since Law 4/2017, of March 9, on the “Rights and Guarantees of People in the Process of Dying”, there is a right to receive quality palliative care at this state. In Spain 120,000 patients per year requires specialized palliative care but there is only coverage for a 50% of them. Our aim is to evaluate end of life palliative care cost compared to other hospital services in a first line hospital. And the financial balance of the palliative care unit (H-PCU), considering the earnings and humans resources cost since 2016 to 2018.

METHODS

Cost evaluation from the hospital perspective including treatments (pharmacological, chemotherapies, nutrition, transfusions), diagnostic test (imagen and blood test) and human resources (physician and nurse practitioner specialized in PC). Data from the unitary cost was provided from the Quiron Health Public Hospitals financial department, hospital pharmacy service and the dead patients registry from 2016 until 2018 with the resources consumed from Casiopea® system. Other data like the diagnostic test cost were taken from the Madrid and Osakidetza Community Official Public Price List. All cost expressed in 2020 euros.

RESULTS

1389 patients died in Hospital Universitario Infanta Elena (HUIE) since 2016 until 2018. 31,1% in the H-PCU and 68,9% in other services. No differences were found in the basal patient’s characteristics (risk of death and severity index included). The median total cost was statistically significant lower (p<0,0001) for the H-PCU (230.35€) compared to the other services (479.32€) with a 248.97€ median earning per patient. Also, earnings are found when we include human resources cost, 21,054.91€ in 2016, 24,232.26€ in 2017 and 18,768,4€in 2018.

CONCLUSIONS

Having the same risk of mortality, it is cheaper to die in a palliative care service.

Although setting a H-PCU has some cost, it´s still an efficient investment.