A study published in Pallative Medicine compared health and social care costs, quality and their drivers in the last 3 months of life for older adults across England, Ireland and the United States. The study found in the last 3 months of life, more than 80% of the total health and social costs were attributable to hospital care and the costs of palliative care were only ~10%, despite the fact that all patients had accessed specialist palliative care.
A mortality follow-back survey of informal carers of decedents who had received palliative care was conducted in palliative care services in England (London), Ireland (Dublin) and the United States (New York, San Francisco).
The study concluded poverty and poor home care drove high costs, suggesting that improving community palliative care may improve care value, especially as palliative care expenditure was low. Major diagnostic variables were not cost drivers. Care costs in the United States were high and highly variable, suggesting that high-cost low-value care may be prevalent.