CONSTRUCTION AND PRELIMINARY APPLICATION OF COST ESTIMATION TOOL FOR HOME-BASED PALLIATIVE CARE

Zhiheng Zhou*, Zeling Zhu, Weiliang Zhu, Tingjun Li, Lishu Lin and Honglian Xie

ABSTRACT

Background: Home-based palliative care is an effective method for improving the quality of life for terminally ill patients, but it is still in its infancy in China, with limited reports on cost assessments. Objective: This study aimed to develop a cost assessment index system and evaluation tool for home-based palliative care applicable in China, conduct preliminary applications, understand the costs of home-based palliative care in Chinese cities, and provide scientific basis for government compensation, resource allocation, and service optimization. Results: Literature review, expert interviews, consultations, questionnaires, and field observations were used to establish a cost assessment index system for home palliative care, which includes two dimensions (primary indicators): healthcare team and medical costs, and home care and caregiver costs, with five secondary indicators and sixteen tertiary indicators. In Shenzhen, 50 patients receiving home palliative care between 2023 and 2024 and their families were selected as research subjects. The costs were evaluated through big data analysis and questionnaire surveys. The results showed that the total cost per patient for community palliative care was approximately 74,100 yuan, with home care and caregiver costs (58.3%) significantly higher than healthcare team and medical costs (32.1%). Additionally, family caregivers spent an average of 6.2 hours daily, equivalent to an implicit economic cost of 4,120 RMB yuan per month. Conclusions: This study is the first to develop a cost assessment index system and evaluation tool for home-based palliative care applicable in China, revealing that the implicit costs borne by families are significantly higher than professional service costs. The Chinese government should increase policy support, establish a tripartite cost-sharing mechanism involving the government, families, and society, optimize resource allocation, and enhance the effectiveness and efficiency of community palliative care.

Keywords: Palliative care, Cost, Index system, Evaluation tool.