Use of resources and costs of palliative care with parenteral fluids and analgesics in the home setting for patients with end-stage cancer

Background. In 1992 a home care technology project was started in which inf usion therapy in the home settings was made available for patients with end -stage cancer. Beside aspects of feasibility and quality of life the resour ce utilization and costs of this transition was studied. Patients and methods: We conducted a cost evaluation study, to determine th e actual cost of managing patients with endstage cancer who require parente ral administration of fluid or analgesics in the home setting. A total of 1 28 patients were prospectively followed, with a detailed analysis of some a spects in a sample of 24 patients. Results: The cost for each patient was found to be between $250.00 and $300 .00 per day, half of which are for hospital charges, even with this active home care technology program. One-third of the costs can be attributed to p rimary health care activities, in particular those of the district nurses. A hypothetical control group (n = 25) was constructed based on current prac tice and chart review. Patients in this group would have cost around $750.0 0 per day. With a median treatment period of 16 days this means a saving of $8000.00 per patient. Conclusion: Our data suggest that significant savings can be obtained by im plementing programs transferring palliative care technology to the home set ting.