Table 5: Effect of pediatric palliative care programs versus usual care on costs
Study*SummaryOutcome
Postier et al. (18)DecreaseMean charges ± SD (factor of $10 000): 20.97 ± 43.3 before v. 10.91 ± 21 after intervention; < 0.001
Interaction: level of exposure to program, cancer/noncancer, study period (p < 0.001)
Knapp et al. (15)IncreaseTotal mean expenditures (hospice v. nonhospice users):
  All causes of death: $83 719 v. $36 597
  Perinatal: $112 723 v. $78 218
  Chronic: $84 047 v. $66 584
  [Note: The total cost is the sum of the mean expenditures per type (inpatient, outpatient, hospice and pharmacy). For more details visit the primary article.]
Keele et al. (12)DecreaseMedian (IQR) daily charges, adjusted for geography: $9348 ($6070–$15 318) in intervention group v. $11 806 ($8017 to $18 352) in control group; < 0.001
Smith et al. (19)IncreaseChange in median daily cost (IQR) within intervention group: $3827 ($2.9K–3.9K) before v. $4013 ($3.1K–5.1K) after intervention; p = 0.06
Median daily cost (IQR) in 2010/11: $3.8K ($3.1K–$4.7K) in intervention group v. $3.4K ($2.7K–$4.5K) in control group; = 0.001
Ward-Smith et al. (17)No difference/
controversial
Mean hospital costs (range), excluding surgical charges: $78 780 ($33 283 to $130 970) in intervention group v. $81 780 ($28 970 to $135 432) in control group
Gans et al. (5)DecreaseMean total medical expenditures per patient per mo: $15 653 before v. $13 976 after intervention
11% decrease overall: nearly $1 million in 18 mo (35% decrease inpatient care costs [$3571]; 34% increase in outpatient care costs [$1398]; 35% increase in pharmaceutical costs [$495])
Pascuet et al. (13)DecreaseChange in total inpatient costs per mo (hospital + hospice):
–$4252 (95% CI –$953 to –$7551) after intervention; = 0.012
Unit costs per d: $2007 hospital inpatient v. $500 hospice
Belasco et al. (16)DecreaseMean charges per d (hospital v. home):
  Acute myeloid leukemia (toddler): $4283 v. $17
  Neuroblastoma (preschool child): $2300 v. $325
  Multiple chronic diseases (teenager): $8258 v. $1308

Note: CI = confidence interval, IQR = interquartile range, SD = standard deviation.
*Studies listed according to outcome measurement and quality-assessment rank.