How to work out the costs of providing palliative care

Recently the Journal of Pain and Symptom Management published an article on how to cost palliative care services. The team at Hospice Casa Sperantei in Romania developed a methodology for determining palliative care cost per inpatient day.

They also developed a way to measure cost per visit, cost per month, and cost per case for home care services. These methods and results are described and a link to download an excel template is provided so that an individual provider or a country could substitute their own local costs to do the same analysis. 

In most countries no one knows the cost to deliver palliative care, so it is difficult to ask governments to provide financial support to palliative care providers that are often community based organizations. In order to negotiate reimbursement rates, providers need to know these costs, which vary considerably due to local salaries and costs for medicines, supplies, transportation, and so forth. 

In Romania it was found that it costs only $96.58 USD to care for an inpatient for one day. Average cost for all disciplines for a home care visit was $30.37 and for a month of home visits, $723.60. 

On average, a patient required 45 visits during an episode of home care, which cost $1,367.71. Local conditions and standards of care may vary somewhat and medicine costs vary widely and are sometimes covered and sometimes not. Including all these factors into the analysis is necessary to get an accurate idea of costs. 

Having these figures is crucial to advocacy for palliative care implementation and expansion of service delivery in any country. 

The authors developed templates in Microsoft Excel to enable national and local organisations to substitute their own local costs to do this analysis for their own country.

Download the model for costing framework of a home based care visit and the model for costing framework for inpatient units from the WHPCA website.

This project was supported by the Open Society Foundation’s Public Health Program, the International Palliative Care Initiative. 

Reference

Mosoiu D, Dumitrescu M, & Connor, SR. Developing a costing framework for palliative care services. Journal of Pain & Symptom Management, 2014; 48(4):719-29.