The Size, Share, and predictors of Publicly Financed Healthcare Costs in the Home Setting over the Palliative Care Trajectory: A Prospective Study

Abstract

Introduction: The increasing attention on home-based service provision for end-of-life care has resulted in greater financial demands being placed on family caregivers. The purpose of this study was to assess publicly financed costs within a home-based setting from a societal perspective. Methods: A pro spective cohort study design was employed. In all, 129 caregivers of palliative care patients were interviewed biweekly for a total of 667 interviews. Multiple regression analysis (log-linear regression and seemingly unrelated regression [SUR]) was conducted. Results: While publicly financed costs accounted for 20 percent of the full economic costs and increased with proximity to death, 76.7 percent of costs were borne by patients’ caregivers in the form of unpaid caregiving. The share of publicly financed healthcare costs was driven by patients’ and caregivers’ sociodemographic and clinical characteristics. Conclusion: These findings warrant affording greater attention to policies and interventions intended to reduce the economic burden on palliative patients and their caregivers.