Evaluating the Cost-Effectiveness of Home-Based Palliative Care for Children with Special Health Care Needs: A Review Study

Abstract

Background Due to the increased survival of children with chronic and complex diseases, transferring a part of care provision to home and harnessing the family’s potential with the aim of shortening the length of stay and returning the child to the safe and familiar atmosphere of the family can affect the health system and the family. This study aimed to evaluate the cost-effectiveness of home-based palliative care for children with complex health care needs based on the literature review. Materials and Methods: After selecting the keywords related to the research question, by examining MeSH, EMTREE and the experts’ opinions mentioned in articles, searching the databases PubMed/Medline, EMBASE, Scopus and Web of Science was done through a combination of them. Results: Finally, 11 studies met the inclusion criteria, which were investigated in three groups of methodological features, economic outcomes and indirect outcomes. The reviewed studies were of medium to high quality. Eight were cohort studies, one pre-post study, and 2 economic evaluation studies. Studiesshowed that the decrease in the costs of home-based palliative care for the children in need of special health care, although little, was the result of either reduced hospital stay or the decreased number of hospitalizations. Conclusion In order to set up pediatric palliative care services in Iran, considering the cultural atmosphere and the limited resources of the health system, attention should be paid to the cost effectiveness of care settings and the provided services, and measures should be taken in order to improve the situation of the children with special care needs, based on social conditions.