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What is the cost of palliative care in the UK? A systematic review
  1. Clare Gardiner1,
  2. Tony Ryan1 and
  3. Merryn Gott2
  1. 1 School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
  2. 2 School of Nursing, The University of Auckland, Auckland, New Zealand
  1. Correspondence to Dr Clare Gardiner, School of Nursing and Midwifery, The University of Sheffield, Sheffield S10 2LA, UK; c.gardiner{at}


Objectives Little is known about the cost of a palliative care approach in the UK, and there is an absence of robust activity and unit cost data. The aim of this study was to review evidence on the costs of specialist and generalist palliative care in the UK, and to explore different approaches used for capturing activity and unit cost data.

Methods A systematic review with narrative synthesis. Four electronic databases were searched for empirical literature on the costs of a palliative care approach in the UK, and a narrative method was used to synthesise the data.

Results Ten papers met our inclusion criteria. The studies displayed significant variation in their estimates of the cost of palliative care, therefore it was not possible to present an accurate aggregate cost of palliative care in the UK. The majority of studies explored costs from a National Health Service perspective and only two studies included informal care costs. Approaches to estimating activity and costs varied. Particular challenges were noted with capturing activity and cost data for hospice and informal care.

Conclusion The data are limited, and the heterogeneity is such that it is not possible to provide an aggregate cost of palliative care in the UK. It is notable that the costs of hospice care and informal care are often neglected in economic studies. Further work is needed to address methodological and practical challenges in order to gain a more complete understanding of the costs of palliative care.

  • palliative care
  • economic
  • cost
  • resource utilisation
  • systematic review

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  • Contributors CG conceived the study, undertook data collection and led on analysis and writing drafts. MG and TR contributed to data analysis and commented on drafts of the paper.

  • Funding This research was funded through a Vice Chancellors Fellowship at the University of Sheffield.

  • Competing interests None declared.

  • Patient consent Not required.

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

  • Data sharing statement Data are available on request from the authors.