Resource Consumption and Costs of Palliative Care Services in Spain: A Multicenter Prospective Study

Patients (n ¼ 395) with terminal-stage cancer receiving attention from palliative care services (PCSs) were recruited over a period of 15 consecutive days from 171 participating PCS units. Resource consumption and costs were evaluated for 16 weeks of follow-up, and the findings were compared with a study conducted in 1992 so as to assess change over time. The most frequent health care interventions were homecare visits, hospital admissions, and patient-consultant phone calls. PCS provided 67% of all services and consultation interventions in 91% of patients. Compared with the historical data, there was a significant shift from the use of conventional hospital beds toward palliative care beds, a reduced hospital stay (25.5--19.2 days; P ¼ 0.002), an increase in the death-at-home option (31%--42%), a lower use of hospital emergency rooms (52%--30.6%; P ¼ 0.001), and an increase in programmed care. Compared to the previous resource consumption and expenditure study in 1992, the current PCS policy implies a cost saving of 61%, with greater efficiency and no compromise of patient care. J Pain Symptom Manage 2006;31:522--532. 2006 U.S.