TY - JOUR T1 - Is home-based palliative care cost-effective? An economic evaluation of the Palliative Care Extended Packages at Home (PEACH) pilot JF - BMJ Supportive & Palliative Care JO - BMJ Support Palliat Care SP - 431 LP - 435 DO - 10.1136/bmjspcare-2012-000361 VL - 3 IS - 4 AU - Nikki McCaffrey AU - Meera Agar AU - Janeane Harlum AU - Jonathon Karnon AU - David Currow AU - Simon Eckermann Y1 - 2013/12/01 UR - http://spcare.bmj.com/content/3/4/431.abstract N2 - Objective The aim of this study was to evaluate the cost-effectiveness of a home-based palliative care model relative to usual care in expediting discharge or enabling patients to remain at home. Design Economic evaluation of a pilot randomised controlled trial with 28 days follow-up. Methods Mean costs and effectiveness were calculated for the Palliative Care Extended Packages at Home (PEACH) and usual care arms including: days at home; place of death; PEACH intervention costs; specialist palliative care service use; acute hospital and palliative care unit inpatient stays; and outpatient visits. Results PEACH mean intervention costs per patient ($3489) were largely offset by lower mean inpatient care costs ($2450) and in this arm, participants were at home for one additional day on average. Consequently, PEACH is cost-effective relative to usual care when the threshold value for one extra day at home exceeds $1068, or $2547 if only within-study days of hospital admission are costed. All estimates are high uncertainty. Conclusions The results of this small pilot study point to the potential of PEACH as a cost-effective end-of-life care model relative to usual care. Findings support the feasibility of conducting a definitive, fully powered study with longer follow-up and comprehensive economic evaluation. ER -