Table 1.

Cost categories captured in the end-of-life empirical literature, by study.

		Public		Private
Study (Authors' Names)	Economic study objectives and design Health service utilization/measured costs	In-patient	Home and ambulatory	Out-of-pocket	Time losses (labour market)	Time losses (Household work/leisure)	Third party insurance
Axelsson and Christensen [28]	Hospitalization costs of patients enrolled in a home-based palliative care service were compared with a matched historical cohort receiving institutionally based care and a cohort of patients eligible for but not receiving the palliative service (Sweden). Measured costs: in-patient days from diagnosis to death, number of admissions, duration terminal hospitalization.	×
Bruera et al. [4]	A retrospective study comparing acute-care costs in terminally ill patients during their last hospital admission prior to and after implementation of a regional palliative care program. Measured costs: number of cancer deaths, mean LOS, total number of in-patient days, palliative hospice care and consult teams, physician and specialist billings (Canada).	×	×
Brumley et al. [3]	A prospective study comparing service utilization of a palliative care program with regular home health care (California). Measured costs: ED visits, physician office visits, hospital days, skilled nursing facility days, home health and palliative visits days on hospice.	×	×
Brumley et al. [29]	A randomized controlled trial to evaluate the ability of an in-home palliative care program to reduce medical costs in comparison to standard care. Measured costs: emergency visits, physician office visits, hospital days, skilled nursing facility days, home health and palliative care visits, palliative physician home visits, days on hospice.	×	×
Chan et al. [6]	A prospective study to determine the societal cost a palliative care program from first admission until death (Hong Kong). Measured costs: in-patient care (hospital and hospice), outpatient services, Chinese and herbal medicines, supplies privately obtained, income lost by patients/caregivers.	×	×	×	×
Cowan [30]	Review of administrative data to evaluate costs of an in-patient palliative care consultation service compared with inpatients receiving usual care (USA). Measured costs: Hospital length of stay and hospital charges.	×
Dumont et al. [7]	A prospective study of palliative care to compare resource utilization, service use, and associated costs in five regions across Canada. Measured costs: in-patient days, out patient visits, home care visits, phone calls, medical equipment use, transportation costs, caregiver time spent on household chores, errands, and personal care for the patient.	×	×	×		×
Elsayem et al. [31]	Retrospective review of in-patient costs associated with patients enrolled in a Palliative Care In-patient Service (USA). Measured costs: number of inpatient days and hospital billing.	×
Fassbender et al. [2]	Retrospective review (administrative databases) to evaluate health system costs of palliative care before and after implementation of a community-based palliative care service (Canada). Measured costs: community care, in-patient, physician, and medications.	×	×
Gόmez-Batiste et al. [32]	Prospective multicentre study to compare in-patient costs and resource utilization of a palliative care service compared with historical data prior to implementation of the service (Spain). Measured costs: in-patient acute care, in-patient palliative care, ED visits, palliative care outpatient clinic, physician visits.	×	×
Hanson et al. [33]	Prospective case-control study to determine the impact of palliative care consultations on hospital costs of terminally ill hospitalized patients (USA). Total hospital costs, length of stay, average daily costs.	×
Johnson et al. [34]	Pilot study to evaluate service use and costs of a home-based palliative care program (Canada). Measured costs: personnel support, laboratory tests, nursing visits, nutritional counseling, occupational therapy, medical supplies and equipment, medications.		×
Oliver et al. [35]	A retrospect chart analysis to determine resource use and costs of patients diagnosed with small lung cell carcinoma from diagnosis until death (United Kingdom). Measured costs: in-patient days, outpatient visits, investigations, laboratory tests, medications, radiotherapy fractions, hospice in-patient days and outpatient visits, community nursing visits, social service support consultations.	×	×
Penrod et al. [36]	Retrospective analysis of administrative data to examine hospital utilization and direct costs of a palliative care consultation program in comparison to usual care in two centers (USA). Measured costs: LOS, ICU LOS, medical supplies, laboratory and radiology services, physician, nursing, contract, and all other labour.	×
Shnoor et al. [5]	Retrospective case-control cost analysis of patients receiving home hospice services in comparison to conventional health services in the two months prior to death (Israel). Measured costs: medications, laboratory tests, radiographs, imaging, home and hospital procedures, medical equipment, in-patient days, ED visits, surgical procedures, any other treatment for which the service providers were paid.	×	×	×			×
Smith et al. [37]	Case-control study to measure the cost of care in a dedicated in-patient palliative care unit. Daily costs of the palliative care unit were compared to in-patient costs prior to transfer to unit, as well as to patients who died using conventional medical services. Measured costs: daily charges in-patient and costs of days prior to transfer to palliative care unit.	×
Tamir et al. [38]	Retrospective review of administrative databases to compare health service utilization during the last year of life in patients receiving home-specialized palliative care with nonspecialized care (Israel). Measured costs: ambulatory procedures, laboratory, imaging, consultations, in-patient costs and LOS, ED visits, physician visits, oncology treatments.	×	×
White et al. [39]	Longitudinal case study to measure costs of a hospital-based palliative care unit in the 20 days prior to death. Costs of care were compared between the palliative care unit, the ICU, and other units. Measured costs: average cost per day of patients who died in the hospital.	×