A forthcoming special edition of Palliative Medicine will focus on the economics of palliative and end of life care. Guest editors, Professor Joanna Coast, University of Bristol, UK, Dr Nikki McCaffrey, Flinders University, Australia and Dr Brian Cassel, Virginia Commonwealth University Medical Center, USA, invite you to contribute a paper on this important topic.
What does the ‘economics of palliative and end of life care’ make you think about? Dusty boxes of invoices? Spreadsheets? Hospital costing and administration systems? If so, you may be thinking that this is going to be a very dull special edition and something that you wouldn’t be interested in either reading or contributing to. We hope that we can change your mind!
Economics, as it is applied to health and care, has many more interesting concerns. One of these, which economists call efficiency, concerns how we can get the very best care for patients and their families within the resources that are available. Resources might be money, but they might also be other things. Imagine a hospice (or palliative care unit) where there is an influx of new volunteers – how might this extra resource be used to get most benefit? By providing companionship to patients, or by providing receptionist services to give a friendly welcome to family and friends as they visit the hospice to make them feel at home? Or by gardening to improve the environment?
There are many economic questions around palliative and end of life care that are still unresolved. Some of these are questions such as the one above, about comparing different options in terms of their value for money: the benefits obtained for the resources used. These might be options for pain control or control of symptoms, but they might also be concerned with where care is located, or the timing of care, or who provides care.
Other questions focus on methods, such as how best to measure the benefits of care and the costs of care. In terms of benefits, are we just concerned about health improvements, or are we concerned about broader issues such as patient dignity? And how much weight do we put on these different benefits: is it more important to reduce physical discomfort or to enable people to be with their families, for example? In terms of costs, are we just interested in costs to providers, or do we also want to include the costs to families and friends?
Still more questions focus on broader issues at the service level. These might include concentrating on what we can expect future demand for palliative and end of life care to be, considering issues such as population change. They might also include looking at possible service redesign and the impact that might have on future provision of care. Or, they might focus on how different aspects of the system are integrated to provide care through market and/or other funding mechanisms, possibly comparing across different international systems.
There is currently limited evidence about the efficiency and equity of palliative and end of life care, and the area has been neglected relative to many other areas of health care provision. As demands on health and social care systems continue to rise, such economic analysis is increasingly important. The special edition of Palliative Medicine will address this increasingly important area. The aim is to publish rigorous empirical original research, reviews, research methodologies or theoretical works with an economic focus from across health and social care.
Would you like to submit a paper on the economics of palliative and end of life care?
If you are interested in submitting a paper for this special edition of Palliative Medicine, please view more information here. Or, visit our website and follow the links to ‘submit a manuscript’. (If you have any problems, please email Debbie Ashby, Editorial Manager).
Deadline for submissions: 18 April 2016.