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Palliative cancer care: costs in a Brazilian quaternary hospital
  1. Luciana Martins Rozman1,
  2. Alessandro Gonçalves Campolina2,
  3. Rossana Mendoza Lopez2,
  4. Toshio Chiba2 and
  5. Patricia Coelho De Soárez1
  1. 1 Departamento de Medicina Preventiva, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil
  2. 2 Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas Instituto do Cancer, Sao Paulo, Brazil
  1. Correspondence to Dr Luciana Martins Rozman, Preventive Medicine, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo 01246-903, Brazil; lm.rozman{at}


Palliative care (PC) improves the quality of life of patients with diseases such as cancer, and several studies have shown a reduction in costs among patients who use PC services when compared with those receiving standard oncological treatments. Most studies on PC costs are carried out in high-income countries. There is a lack of these types of studies in middle-income and low-income countries and of better evidence about this intervention.

Objective To describe resource utilisation and costs among patients with cancer in a Brazilian quaternary hospital by cancer localisation and per month of treatment before death.

Methods This study is a description of retrospective costs to estimate the costs of formal healthcare sector associated with PCs, from the perspective of a public quaternary cancer hospital. Unit costs were estimated using microcosting and macrocosting approaches.

Setting/Participants Patients older than 18 years old who died from 2010 to 2013 and who had at least two visits in PC and/or made use of hospice care.

Results Among the 2985 patients included in the study, the average cost per patient was US$12 335, ranging from US$8269 for patients with pancreatic cancer to US$19 395 for patients with brain cancer. The main costing item was hospital admission (47.6% of the total cost), followed by hospice care (29.5%) and medical and other supplies (11.1%).

Conclusions The study clarified the direct medical costs and the profile and use of resources of patients with cancer who need PC, and can help in the planning and allocation of resources in cancer care.

  • palliative care
  • costs
  • cancer

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors LMR conceptualised and designed the study, carried out the initial analyses, drafted the manuscript, and revised the manuscript. AGC conceptualised and designed the study. RML carried out the analyses. TC critically reviewed the manuscript. PCDS conceptualised and designed the study, supervised the study, and critically reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.