Table 12:
Cost-Effectiveness Analysis
| Intervention | Health Outcomes | |||||||
|---|---|---|---|---|---|---|---|---|
| Cost, $ | Days at Home | Dying at Home, % | QALD, Patients | QALD, Caregivers | Total QALD | Cost per QALY | Categorya | |
| Usual care | 50,129 | 336.05 | 45.41 | 198.71 | 319.82 | NA | NA | Absolute values |
| Palliative Team Care | ||||||||
| PTC: In-home | −4,424 | 5.75 | 10.32 | 0.44 | 0.03 | 0.47 | Dominant | Incremental effect (I-C) |
| PTC: Inpatient | −1,643 | 0.65 | −0.15 | 0.26 | 0.00 | 0.27 | Dominant | Incremental effect (I-C) |
| PTC: Comprehensive | 527 | 1.44 | 1.74 | 2.64 | 0.01 | 2.65 | 72,717 | Incremental effect (I-C) |
| Patient Care Planning Discussions | ||||||||
| PCPD: Identifying LTC residents with EoL goals and preferences for EPC | −26 | 0.07 | 0.00 | 0.0049 | 0.0004 | 0.0053 | Dominant | Incremental effect (I-C) |
| PCPD: Ethics consultation for ICU patients with treatment conflicts | −85 | 1.05 | 0.31 | 0.09 | 0.01 | 0.10 | Dominant | Incremental effect (I-C) |
| PCPD: Improving family conferences for relatives of patients dying in ICU | 56 | 0.01 | −0.12 | 0.00 | 0.49 | 0.49 | 41,690 | Incremental effect (I-C) |
| Educational Interventions for Patients and Caregivers | ||||||||
| Multicomponent psychoeducational interventions for patients and families | 4,766 | −4.35 | −5.72 | 1.98 | 1.65 | 3.63 | 479,509 | Incremental effect (I-C) |
| Supportive Interventions for Informal Caregivers | ||||||||
| Supportive interventions for informal caregivers | 196 | 0.00 | 0.00 | 0.00 | 0.82 | 0.82 | 87,205 | Incremental effect (I-C) |
Abbreviations: C, control; EoL, end-of-life; EPC, early palliative care; I, intervention; ICU, intensive care unit; LTC, long-term care; NA, not applicable; PCPD, patient care planning discussion; PTC, palliative team care; QALD, quality-adjusted life-day; QALY, quality-adjusted life-year.
a
Incremental effect is the different between estimates for the intervention and usual care.