{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:30:24Z","timestamp":1789587024990,"version":"build-2803163510"},"reference-count":27,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>Background: In 2019, the S\u00e3o Paulo State Cancer Institute (ICESP) implemented a novel model integrating Oncology with Palliative Care specialists. We evaluated the impact of this model on healthcare resource utilization and costs. Methods: We analyzed data from all patients who passed away in February (1\u00a0month prior to implementation) and November (8\u00a0months after model implementation group) at ICESP, Brazil. Healthcare utilization data, including emergency department visits, hospital and intensive care unit admissions, chemotherapy, and radiotherapy use, were retrieved from Electronic Medical Records. Unit cost values were obtained from the administrative database. Results: A total of 198 patients who died in February and 196 in November were included in the analysis. Groups exhibited similarities in sex, age, ECOG, cancer type, previous outpatient palliative care consultations, and place of death (ward: 56.6% pre-intervention, 50% post-intervention). The mean cost per patient was US$13,226.29 pre-intervention and US$11,445.82 post-intervention ( P = .007). Statistically significant differences were noted in days hospitalized in the surgical ward (227 vs 115), emergency department visits (233 vs 45), chemotherapy sessions (140 vs 26), and radiotherapy sessions (146 vs 10). Excluding outpatient treatments, the total costs for chemotherapy and radiotherapy in the last 30\u00a0days of life were US$16,924.45 pre-intervention and US$7851.65 post-intervention. Reductions were more pronounced in patients with ECOG 3-4 ( P = .039). Conclusion: Our data suggests that the integration model was associated with a reduction in potentially inappropriate treatments during the last month of life, leading to decreased healthcare utilization and costs.<\/jats:p>","DOI":"10.1177\/10499091241232401","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T19:23:00Z","timestamp":1708456980000},"page":"1451-1458","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Oncology and Palliative Care Integration Model: A Cost Analysis Study in a Brazilian Hospital Setting"],"prefix":"10.1177","volume":"41","author":[{"given":"T\u00e2nia V. V.","family":"Guimar\u00e3es","sequence":"first","affiliation":[{"name":"Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0233-0797","authenticated-orcid":false,"given":"Alessandro G.","family":"Campolina","sequence":"additional","affiliation":[{"name":"Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana M.","family":"Rozman","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshio","family":"Chiba","sequence":"additional","affiliation":[{"name":"Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia C.","family":"de So\u00e1rez","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3176-9747","authenticated-orcid":false,"given":"Maria D. P.","family":"Estevez Diz","sequence":"additional","affiliation":[{"name":"Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"bibr1-10499091241232401","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-020-00163-7"},{"key":"bibr2-10499091241232401","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(18)30060-3"},{"key":"bibr3-10499091241232401","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011129.pub2"},{"key":"bibr4-10499091241232401","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2016.70.1474"},{"key":"bibr5-10499091241232401","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx757"},{"key":"bibr6-10499091241232401","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.18.00026"},{"key":"bibr7-10499091241232401","unstructured":"WHO. 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