Table 5: Effect of pediatric palliative care programs versus usual care on costs.
| Study* | Summary | Outcome |
|---|---|---|
| Postier et al.18 |
Decrease |
Mean charges ± SD (factor of $10 000): 20.97 ± 43.3 before v. 10.91 ± 21 after intervention; p < 0.001 Interaction: level of exposure to program, cancer/noncancer, study period (p < 0.001) |
| Knapp et al.15 |
Increase |
Total mean expenditures (hospice v. nonhospice users): All causes of death: $83 719 v. $36 597 Perinatal: $112 723 v. $78 218 Chronic: $84 047 v. $66 584 [Note: The total cost is the sum of the mean expenditures per type (inpatient, outpatient, hospice and pharmacy). For more details visit the primary article.] |
| Keele et al.12 |
Decrease |
Median (IQR) daily charges, adjusted for geography: $9348 ($6070–$15 318) in intervention group v. $11 806 ($8017 to $18 352) in control group; p < 0.001 |
| Smith et al.19 |
Increase |
Change in median daily cost (IQR) within intervention group: $3827 ($2.9K–3.9K) before v. $4013 ($3.1K–5.1K) after intervention; p = 0.06 Median daily cost (IQR) in 2010/11: $3.8K ($3.1K–$4.7K) in intervention group v. $3.4K ($2.7K–$4.5K) in control group; p = 0.001 |
| Ward-Smith et al.17 |
No difference/ controversial |
Mean hospital costs (range), excluding surgical charges: $78 780 ($33 283 to $130 970) in intervention group v. $81 780 ($28 970 to $135 432) in control group |
| Gans et al.5 |
Decrease |
Mean total medical expenditures per patient per mo: $15 653 before v. $13 976 after intervention 11% decrease overall: nearly $1 million in 18 mo (35% decrease inpatient care costs [$3571]; 34% increase in outpatient care costs [$1398]; 35% increase in pharmaceutical costs [$495]) |
| Pascuet et al.13 |
Decrease |
Change in total inpatient costs per mo (hospital + hospice): –$4252 (95% CI –$953 to –$7551) after intervention; p = 0.012 Unit costs per d: $2007 hospital inpatient v. $500 hospice |
| Belasco et al.16 | Decrease | Mean charges per d (hospital v. home): Acute myeloid leukemia (toddler): $4283 v. $17 Neuroblastoma (preschool child): $2300 v. $325 Multiple chronic diseases (teenager): $8258 v. $1308 |
Note: CI = confidence interval, IQR = interquartile range, SD = standard deviation. *Studies listed according to outcome measurement and quality-assessment rank.