A study evaluating the costs and benefits of involving local communities in end-of-life care found a public health approach has significant benefits, with improved patient outcomes and reduced healthcare costs, including fewer hospital admissions.
The study, published in Palliative Care and Social Practice, was led by Professor Samar Aoun, Perron Institute Research Chair in Palliative Care at The University of Western Australia. Collaborators were Senior Biostatistician Natasha Bear, Institute of Health Research, University of Notre Dame, Fremantle and Adjunct Professor Bruce Rumbold, Perron Institute and La Trobe University.
The aim was to assess the effect on healthcare usage of a community-based palliative care program called Compassionate Communities Connectors, where community volunteers deliver practical and social support to people living with advanced, life-limiting illnesses.
“This analysis demonstrated the health care and economic benefits of optimising palliative care services, using home-based and community interventions,” Professor Aoun said.
A total of 43 community-based patients participated in the program during 2020–2022. A comparator population of 172 individuals with advanced life-limiting illnesses was randomly selected from usage data from the same set of health services.
The community-based group had 63 per cent less hospital admissions, 77 per cent less days in hospital, 44 per cent less emergency presentations and frequency of outpatient contacts was twice as high, compared with the comparator group.
“The study results indicated that the Connector program may have shifted individuals away from the hospital system and toward community-based care,” Professor Aoun said.
“Estimated net savings of $518,701 would be achieved from adopting the Connector program, assuming enrolment of 100 patients over an average 6-month participation period,” she explained.
“These findings suggest that investment in the Connectors program can reduce net health sector expenditure while improving outcomes for people with life-limiting illnesses.”
Professor Aoun, WA’s Australian of the Year 2023, said increased demands were being placed on palliative care services, especially with the demographic shift toward an aging population coupled with increased prevalence of complex chronic diseases.
“To maintain accessible and affordable services with a high quality of care across different settings, more sustainable community involvement models of palliative care are required, with a greater emphasis on partnerships between health services, civic institutions and communities,” she said.
“Palliative care requires a broad range of services across all health care sectors. The Connectors program can potentially shift service utilisation patterns away from disproportionate reliance on inpatient care.”
This program trial was supported by the WA Health Translation Network, the Australian Government’s Medical Research Future Fund as part of the Rapid Applied Research Translation, Perron Institute, La Trobe University and the WA Country Health Service – South West.