Skip to main content
SpringerLink
Log in

A cost calculation model for specialist palliative care for patients with non-small cell lung cancer in a tertiary centre

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Goals of work

Five-year survival of patients with non-small cell lung cancer (NSCLC) is below 15%. Therefore, an early integration of palliative care according to the 2002 WHO definition is indispensable. In this paper, we describe methodical and financial aspects of prospective pricing of palliative care within a concept of integrated care for patients with NSCLC in Germany.

Materials and methods

Four structures of palliative care services were defined (hospital support, home care, day care and in-patient care). Prospectively, resource use was estimated, using real cost data from the finance department of the University Hospital. Resource use was forecasted on the basis of operating experience, data of the national core documentation of palliative care patients and recommendations from the European Commission.

Results

Expected average hospital support team services were priced at 483 euros and budgeted for 10% (stage 1) to 90% (stage 4) of patients. Home care (60 visits, 4,573 euros) and day-care (5 visits) services were budgeted for between 5% (stage 1) and 30% (stage 4). The resulting prospective reimbursements range from 393 euros (stage 1) to 2,503 euros (stage 4). In-patient care was excluded from the prospective payments and reimbursed separately.

Conclusions

For the first time, global reimbursements covering palliative care hospital support, home care and day care for patients with NSCLC were prospectively calculated and successfully negotiated. The contractual specification of palliative care services may contribute to transparency and quality in cancer care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bruera E, Sweeney C (2002) Palliative care models: international perspective. J Palliat Med 5:319–327

    Article  PubMed  Google Scholar 

  2. Clark D, ten Have H, Janssens R (2000) Common threads? Palliative care service developments in seven European countries. Palliat Med 14:479–490

    Article  PubMed  CAS  Google Scholar 

  3. Donnelly S, Walsh D, Rybicki L (1995) The symptoms of advanced cancer: identification of clinical and research priorities by assessment of prevalence and severity. J Palliat Care 11:27–32

    PubMed  CAS  Google Scholar 

  4. European Commission (2003) Promoting the development and integration of palliative care mobile support teams in the hospital—The fifth framework programme 1998–2002 "Quality of Life and management of living resources

  5. Fry WA, Phillips JL, Menck HR (1999) Ten year survey of lung lancer treatment and survival in hospitals in the United States. Cancer 86:1867–1876

    Article  PubMed  CAS  Google Scholar 

  6. Kvale PA, Simoff M, Prakash UB (2003) Palliative care. Chest 123:284S–311S

    Article  PubMed  Google Scholar 

  7. Lidstone V, Butters E, Seed PT, Sinnott C, Beynon T, Richards M (2003) Symptoms and concerns amongst cancer outpatients: identifying the need for specialist palliative care. Palliat Med 17:588–595

    Article  PubMed  CAS  Google Scholar 

  8. Nauck F, Radbruch L, Ostgathe C, Fuchs M, Neuwoehner KDS, Lindena G (2002) Kerndokumentation für Palliativstationen. Struktur und Ergebnisqualität. Z Palliativmed 3:41–49

    Article  Google Scholar 

  9. Nowak D, Ochman U, Huber RM, Diederich S (2005) Screening des Lungenkarzinoms-aktueller Stand. Lung Cancer Screening—State of the Art. Pneumologie 59:178–191

    Article  PubMed  CAS  Google Scholar 

  10. Portenoy RK, Thaler HT, Kornblith AB, Lepore JM, Friedlander-Klar H, Coyle N, Smart-Curley T, Kemeny N, Norton L, Hoskins W et al (1994) Symptom prevalence, characteristics and distress in a cancer population. Qual Life Res 3:183–189

    Article  PubMed  CAS  Google Scholar 

  11. Radbruch L, Nauck F, Ostgathe C, Elsner F, Bausewein C, Fuchs M, Lindena G, Neuwoehner K, Schulenberg D (2003) What are the problems in palliative care? Results from a representative survey. Support Care Cancer 1::42–451

    Google Scholar 

  12. Vainio A, Auvinen A (1996) Prevalence of symptoms among patients with advanced cancer: an international collaborative study. Symptom Prevalence Group. J Pain Symptom Manage 12:3–10

    Article  PubMed  CAS  Google Scholar 

  13. Vinod SK, Hui AC, Esmaili N, Hensley MJ, Barton MB (2004) Comparisons of patterns of care in lung cancer in three area health services in New South Wales, Australia. Intern Med J 34:677–683

    Article  PubMed  CAS  Google Scholar 

  14. WHO (2002) National cancer control programmes-policies and managerial guidelines. WHO, Geneva

    Google Scholar 

  15. WHO (2001) World Health Organization, Cancer incidence, mortality and survivalby site for 14 regions of the world. Discussion Paper No. 13. In:

  16. Wiener JM, Tilly J (2003) End-of-life care in the United States: policy issues and model programs of integrated care. Int J Integr Care 3:e24

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Palliative Medicine and Center for Integrated Oncology (CIO), University of Cologne, Cologne, Germany

    Christoph Ostgathe & Raymond Voltz

  2. Department of Internal Medicine I and Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany

    Ronald Walshe, Jürgen Wolf & Michael Hallek

  3. Klinik und Poliklinik für Palliativmedizin, Klinikum der Universität zu Köln, Kerpenerstraße 62, 50924, Cologne, Germany

    Christoph Ostgathe

Authors
  1. Christoph Ostgathe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ronald Walshe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jürgen Wolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Hallek
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Raymond Voltz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christoph Ostgathe.

Additional information

Christoph Ostgathe and Ronald Walshe contributed equally to the manuscript.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ostgathe, C., Walshe, R., Wolf, J. et al. A cost calculation model for specialist palliative care for patients with non-small cell lung cancer in a tertiary centre. Support Care Cancer 16, 501–506 (2008). https://doi.org/10.1007/s00520-007-0337-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-007-0337-5

Keywords

Search

Navigation