End of Life Cost Savings in the Palliative Care Unit Compared to Other Services

Context. Hospital deaths carry a significant healthcare cost that has been confirmed to be lower when palliative care units Objectives. To compare the last admission hospital health care cost of dying in a first-level hospital between the PCU and the rest of the hospital services. Methods. A retrospective, comparative, observational study evaluating costs from the payer perspective on treatments and diagnostic-therapeutic tests performed on patients who die in first-level hospital, comparing whether they were treated by the PCU or another unit (Non-PCU). Patients with a mortality risk > 2 were included according to the Severity of Illness Index (SOI) and Risk of Mortality (MOR). All cost express in euro, median per patient and interquartile range (IQR). Results. From 1,833 patients who died, 1,389 were included, 442 (31.1%) treated by PCU and 928 (68.9%) Non-PCU. Statistical differences were found for the last admission total cost (euro262.8 (euro470.1) for PCU versus euro515.3 (euro980.48) in Non-PCU), daily total cost (euro74.27 (euro127.4) vs euro115.8 (euro142.4) Non-PCU). Savings were maintained when the sample was broken down by diagnosis-related group (DRG) and a multivariate analysis was performed to determine how the different patients baseline characteristics between PCU and Non-PCU patients influenced the results obtained. Conclusions. Data from this study show that cost is significantly lower when the patients are treated by a PCU during their last hospital stay when they pass away. J Pain Symptom Manage 2022;64:495-503. (c) 2022 The Authors. Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine. This is an open access article under the CC BY-NC-ND license (http://

Automated summary

The study shows that the cost is significantly lower when patients receive care from a palliative care unit during their last hospital stay.