Economic analysis of potentially avoidable hospital admissions in patients with palliative care needs

Background: There is a widely acknowledged need to understand more fully the economics of palliative care provision in the UK. In particular, the economic impact of reducing avoidable hospital admissions among patients with palliative care needs has not been extensively researched. Aim: A recent survey of two English hospitals identified patients with palliative care needs and the proportion of these patients whose admission was potentially avoidable. Using these data, the economic impact of avoiding such hospital admissions is estimated. Methods: Costs were estimated by attaching an Health Resource Group (HRG) code to each admission classified as potentially avoidable in order to determine the possible savings to be made. Alternative places of care for these patients were identified and estimates of the cost of supporting patients in these locations were derived using published unit costs. Results: In the two hospitals surveyed, our study suggested that 7% of patients with palliative care needs could have been cared for elsewhere. The estimated cost saving of avoiding these admissions and supporting these patients in the community was pound 1527 for both hospitals over the survey period. This extrapolates to savings of around pound 180 000 per annum. Results were most sensitive to the cost perspective used and the estimated cost of the avoided hospital admissions. This exploratory analysis was limited by small study size and uncertainty in the costings. Conclusions: Further research is required to gain a better understanding of the economic consequences of potentially avoidable hospital admissions and the extent of variations between localities and to clarify disparities in identified costs.