Background: Economic evidence in palliative care is important for making decisions regarding allocation of resources and support patient preferences fo r end-of-life (EOL) care. However, there is limited evidence on the cost-ef fectiveness of palliative and EOL models of care to inform healthcare funding decisions. Aim: To evaluate the cost-effectiveness of providing Palliative Care Extended Packages at Home (PEACH) in addition to usual care to support clients in their wish to be cared for, and die at home. Design: A modelled cost-effectiveness analysis was conducted from a healthcare provi der perspective to estimate the incremental costs, effects and cost effectiveness. Setting/participants: De-identified prospective and retrospective data on the resource use, cost and consequences of the PEACH Packages Program (n = 75) and usual care (n = 95) were collected from three participating local health districts (LHD) data information systems. Results: Mean costs per patient of providing PEACH ($3493) in addition to usual care were offset by lower mean inpatient care ($6392) and emergency department presentation costs ($139). On average, patients receiving PEACH spent an additional four days at home in the last week of life and more died at home (95% vs 49%). If a daily PEACH cost is applied rather than a per package cost, additional savings of $52,544 may be realised. Better prognostic tools could also result in further savings. Conclusions: PEACH is a cost-effective model of care when added to usual care for people in the last week of life as PEACH plus usual care is more effective and less costly than usual care alone.
KeywordsCost-EffectivenessEconomicHome DeathPalliative Care Extended Packages at HomePalliative CareUsual Care
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