Costs and Economics

Costs and Economics

Key Messages

  • Palliative care appears to be economically sensible. [1-3]
  • Few studies have measured informal caregiving or the out-of-pocket costs borne by carers. [2,4,7]
  • The economics associated with hospital avoidance, advance care planning and medical futility still needs to be addressed. [1]


The aged care context in Australia recognises consumer choice with regard to place of care and choice of care. There is an increasing economic evidence base around the effectiveness of palliative care practices but the costs and benefits associated with settings of care, types of care provision and equity between groups is still uncertain.

Evidence Summary

Informal care provided by family is a significant contribution at the national level. [4] The data from the Australian Institute of Health and Welfare (AIHW) reveals that there are many pathways of use for aged care and palliative care resources for older Australians. Each of these could have particular cost implications. [8]

There is a growing evidence base around the economics and costs associated with palliative care provision. This has mainly been around the costs and benefits of palliative care as a treatment option and palliative care provision in the community. The data suggested that palliative care may reduce costs without a reduction in quality of care. [1-3] It is unclear whether benefits apply across all groups with palliative care needs. The costs incurred by families while caregiving have not been as well documented and reviewed. [1-3] Further work is needed to understand the economics associated with hospital avoidance, advance care planning and medical futility.

Most of the evidence relates to palliative care provision with few reviews directly focusing on older people and much of the available data is inconclusive. [1,2,5-7] There is much less known about the implications of the aged care setting. Given the particular characteristics of funding in this industry, research is needed that explores the economics of palliative care approaches to care for older Australians.

Quality Statement

Overall, the quality of the reviews was good.

Page updated 27 May 2021


  • References

  • About PubMed Search

  1. Hodgson C. Cost-effectiveness of palliative care: a review of the literature. Ottawa (ON): Canadian Hospice Palliative Care Association, 2012 Dec.
  2. Gardiner C, Brereton L, Frey R, Wilkinson-Meyers L, Gott M. Approaches to capturing the financial cost of family care-giving within a palliative care context: a systematic review. Health Soc Care Community. 2016 Sep;24(5):519-31. Epub 2015 Jun 22.
  3. Gomes B, Calanzani N, Curiale V, McCrone P, Higginson IJ. Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. Cochrane Database Syst Rev. 2013 Jun 6;(6):CD007760.
  4. Productivity Commission. Caring for Older Australians: Productivity Commission Inquiry Report: Overview. Canberra: Productivity Commission; 2011 Jun. 88 p. Report No.:53.
  5. Gardiner C, Ingleton C, Ryan T, Ward S, Gott M. What cost components are relevant for economic evaluations of palliative care, and what approaches are used to measure these costs? A systematic review. Palliat Med. 2017 Apr;31(4):323-337. doi: 10.1177/0269216316670287. Epub 2016 Sep 27. 
  6. Pham B, Krahn M. End-of-Life Care Interventions: An Economic Analysis. Ont Health Technol Assess Ser. 2014 Dec 1;14(18):1-70.
  7. Salamanca-Balen N, Seymour J, Caswell G, Whynes D, Tod A. The costs, resource use and cost-effectiveness of Clinical Nurse Specialist-led interventions for patients with palliative care needs: A systematic review of international evidence. Palliat Med. 2018 Feb;32(2):447-465. doi: 10.1177/0269216317711570. Epub 2017 Jun 28.
  8. Australian Institute of Health and Welfare (AIHW). Australia's welfare 2015 - in brief [Internet]. 2015 [cited 2017 Oct 3]; AIHW cat no. AUS 193.


The costs and economics of health systems or providers within the palliative care and/or aged care setting. (CareSearch)

Costs of care borne by individual patients, families and carers. (CareSearch)


Costs/Economics of health systems or providers

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