{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:13:48Z","timestamp":1788275628064,"version":"build-2803163510"},"reference-count":53,"publisher":"Scientific Scholar","content-domain":{"domain":["jpalliativecare.com"],"crossmark-restriction":true},"short-container-title":["IJPC"],"abstract":"<jats:p>\n                    To evaluate medical costs associated with palliative care (PC) and hospice care (HC) compared with usual care among patients with terminal cancer, while accounting for variations in cost definitions and models of care. A systematic review and meta-analysis of observational studies were conducted. Literature searches were performed in PubMed, Scopus, and ProQuest (January 2010\u2013July 2025). Eligible studies compared the medical costs of palliative or hospice care with usual care in adult terminal cancer patients. Care models were defined according to study-specific criteria. Data were pooled using a random-effects meta-analysis, and heterogeneity was assessed using the I\n                    <jats:sup>2<\/jats:sup>\n                    statistic. Eighteen studies were included. PC was associated with lower medical costs than usual care (standardised mean difference [SMD] \u22120.31; 95% confidence interval [CI] \u22120.35\u2013\u22120.27;\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.00001), while HC showed greater cost reductions (SMD \u22120.64; 95% CI \u22120.67\u2013\u22120.62;\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.00001). The overall pooled effect favoured palliative-oriented models (SMD \u22120.54; 95% CI \u22120.57\u2013 \u22120.52). However, substantial heterogeneity (I\n                    <jats:sup>2<\/jats:sup>\n                    up to 100%) likely reflects differences in cost components, care models and health system contexts. PC and HC reduce medical costs and support integration into routine oncology and end-of-life care.\n                  <\/jats:p>","DOI":"10.25259\/ijpc_474_2025","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T06:23:11Z","timestamp":1787379791000},"page":"255-263","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medical Costs of Palliative and Hospice Care versus Usual Care in Terminal Cancer: A Systematic Review and Meta-Analysis"],"prefix":"10.25259","volume":"32","author":[{"given":"Nurlelasari","family":"Harahap","sequence":"first","affiliation":[{"name":"Department of Nursing, Politeknik Kesehatan Kementerian Kesehatan Padang, Padang, Indonesia,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vebby Amelia","family":"Edwin","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Politeknik Kesehatan Kementerian Kesehatan Padang, Padang, Indonesia,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halimatun Syakdiyah","family":"Harahap","sequence":"additional","affiliation":[{"name":"Department of Public Health, Universitas Islam Negeri Sumatera Utara, Medan, Indonesia,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"10.25259\/IJPC_474_2025\/ref-1","doi-asserted-by":"publisher","first-page":"e1750","DOI":"10.1016\/S2214-109X(21)00408-3","article-title":"Palliative care and catastrophic costs in Malawi after a diagnosis of advanced cancer: A prospective cohort study","volume":"9","author":"Jane Bates","year":"2021","journal-title":"Lancet Glob Health"},{"key":"10.25259\/IJPC_474_2025\/ref-2","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/s41669-023-00446-7","article-title":"Specialist palliative care and health care costs at the end of life","volume":"8","author":"Kenny","year":"2024","journal-title":"Pharmacoecon Open"},{"key":"10.25259\/IJPC_474_2025\/ref-3","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1200\/OP.24.00390","article-title":"What is the value of palliative care for inpatients with cancer?","volume":"21","author":"Sedhom","year":"2025","journal-title":"JCO Oncol Pract"},{"key":"10.25259\/IJPC_474_2025\/ref-4","doi-asserted-by":"publisher","first-page":"1514098","DOI":"10.3389\/fpubh.2025.1514098","article-title":"Implementing value-based healthcare: A scoping review of key elements, outcomes, and challenges for sustainable healthcare systems","volume":"13","author":"Khalil","year":"2025","journal-title":"Front Public Health"},{"key":"10.25259\/IJPC_474_2025\/ref-5","doi-asserted-by":"publisher","first-page":"3307","DOI":"10.1002\/cncr.29485","article-title":"Impact of aggressive management and palliative care on cancer costs in the final month of life","volume":"121","author":"Cheung","year":"2015","journal-title":"Cancer"},{"key":"10.25259\/IJPC_474_2025\/ref-6","doi-asserted-by":"publisher","first-page":"e69","DOI":"10.1016\/j.jpainsymman.2025.09.020","article-title":"Economic benefits of investment in palliative care: An appraisal of current evidence and call to action","volume":"71","author":"Gwyther","year":"2026","journal-title":"J Pain Symptom Manage"},{"key":"10.25259\/IJPC_474_2025\/ref-7","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s12904-021-00782-7","article-title":"Evidence on the economic value of end-of-life and palliative care interventions: A narrative review of reviews","volume":"20","author":"Luta","year":"2021","journal-title":"BMC Palliat Care"},{"key":"10.25259\/IJPC_474_2025\/ref-8","doi-asserted-by":"publisher","first-page":"e183","DOI":"10.1200\/OP.21.00299","article-title":"Effect of early palliative care on end-of-life health care costs: A population-based, propensity score-matched cohort study","volume":"18","author":"Seow","year":"2022","journal-title":"JCO Oncol Pract"},{"key":"10.25259\/IJPC_474_2025\/ref-9","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.2147\/CMAR.S472649","article-title":"Systematic review of the cost-effectiveness of home-based palliative care interventions in patients with cancer: A critical analysis","volume":"16","author":"Maresova","year":"2024","journal-title":"Cancer Manag Res"},{"key":"10.25259\/IJPC_474_2025\/ref-10","doi-asserted-by":"publisher","first-page":"6175","DOI":"10.1007\/s00520-021-06288-5","article-title":"How palliative care teams can mitigate financial toxicity in cancer care","volume":"29","author":"Sedhom","year":"2021","journal-title":"Support Care Cancer"},{"key":"10.25259\/IJPC_474_2025\/ref-11","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1177\/0022167813504036","article-title":"An empirical investigation of viktor frankl's logotherapeutic model","volume":"54","author":"Joshi","year":"2014","journal-title":"J Humanist Psychol"},{"key":"10.25259\/IJPC_474_2025\/ref-12","doi-asserted-by":"publisher","first-page":"407","DOI":"10.3961\/jpmph.24.090","article-title":"Beyond medical bills: High prevalence of financial toxicity and diverse management strategies among Vietnamese patients with cancer","volume":"57","author":"Tran","year":"2024","journal-title":"J Prev Med Public Health"},{"key":"10.25259\/IJPC_474_2025\/ref-13","doi-asserted-by":"publisher","first-page":"e0167976","DOI":"10.1371\/journal.pone.0167976","article-title":"Resilience and associated factors among mainland Chinese women newly diagnosed with breast cancer","volume":"11","author":"Wu","year":"2016","journal-title":"PLoS One"},{"key":"10.25259\/IJPC_474_2025\/ref-14","doi-asserted-by":"publisher","first-page":"421","DOI":"10.3390\/healthcare13040421","article-title":"The economic cost of nursing care of palliative patients in the emergency department","volume":"13","author":"Dos Santos Afonso","year":"2025","journal-title":"Healthcare (Basel)"},{"key":"10.25259\/IJPC_474_2025\/ref-15","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1089\/jpm.2015.0476","article-title":"Cost analysis of a randomized trial of early palliative care in patients with metastatic nonsmall-cell lung cancer","volume":"19","author":"Greer","year":"2016","journal-title":"J Palliat Med"},{"key":"10.25259\/IJPC_474_2025\/ref-16","doi-asserted-by":"publisher","first-page":"26323524241299819","DOI":"10.1177\/26323524241299819","article-title":"Financial cost of end-of-life cancer care in palliative care units (PCUs) and non-PCUs in Iran: Insights from low-and middle-income countries","volume":"18","author":"Darrudi","year":"2024","journal-title":"Palliat Care Soc Pract"},{"key":"10.25259\/IJPC_474_2025\/ref-17","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1186\/s12913-023-09578-2","article-title":"The effects of hospice care on healthcare expenditure among cancer patients","volume":"23","author":"Jhang","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"10.25259\/IJPC_474_2025\/ref-18","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.jpainsymman.2022.06.016","article-title":"End of life cost savings in the palliative care unit compared to other services","volume":"64","author":"Abian","year":"2022","journal-title":"J Pain Symptom Manage"},{"key":"10.25259\/IJPC_474_2025\/ref-19","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1111\/ajco.13882","article-title":"Comparison of direct medical care costs between patients receiving care in a designated palliative care unit and the usual care units","volume":"19","author":"Chanthong","year":"2023","journal-title":"Asia Pac J Clin Oncol"},{"key":"10.25259\/IJPC_474_2025\/ref-20","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.1177\/1049909120986800","article-title":"Cost savings associated with palliative care among older adults with advanced cancer","volume":"38","author":"Sheridan","year":"2021","journal-title":"Am J Hosp Palliat Care"},{"key":"10.25259\/IJPC_474_2025\/ref-21","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1080\/0284186X.2020.1806356","article-title":"End-of-life care among patients with pancreatic cancer with or without palliative intervention: A retrospective single-centre study","volume":"60","author":"Rautakorpi","year":"2021","journal-title":"Acta Oncol"},{"key":"10.25259\/IJPC_474_2025\/ref-22","doi-asserted-by":"publisher","first-page":"e0229176","DOI":"10.1371\/journal.pone.0229176","article-title":"Differences in medical costs for end-of-life patients receiving traditional care and those receiving hospice care: A retrospective study","volume":"15","author":"Huang","year":"2020","journal-title":"PLoS One"},{"key":"10.25259\/IJPC_474_2025\/ref-23","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1016\/j.jpainsymman.2018.08.015","article-title":"Improving value of care for older adults with advanced medical illness and functional decline: Cost analyses of a home-based palliative care program","volume":"56","author":"Chen","year":"2018","journal-title":"J Pain Symptom Manage"},{"key":"10.25259\/IJPC_474_2025\/ref-24","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1177\/0269216317690098","article-title":"Cost analysis of a prospective multi-site cohort study of palliative care consultation teams for adults with advanced cancer: Where do cost-savings come from?","volume":"31","author":"May","year":"2017","journal-title":"Palliat Med"},{"key":"10.25259\/IJPC_474_2025\/ref-25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12904-016-0075-x","article-title":"How different is the care of terminal pancreatic cancer patients in inpatient palliative care units and acute hospital wards? A nationwide population-based study","volume":"15","author":"Wang","year":"2016","journal-title":"BMC Palliat Care"},{"key":"10.25259\/IJPC_474_2025\/ref-26","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1001\/jamaoto.2015.2162","article-title":"The cost of hospice services in terminally Ill patients with head and neck cancer","volume":"141","author":"Enomoto","year":"2015","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"10.25259\/IJPC_474_2025\/ref-27","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.jpainsymman.2015.02.023","article-title":"Cost savings associated with an inpatient palliative care unit: Results from the first two years","volume":"50","author":"Nathaniel","year":"2015","journal-title":"J Pain Symptom Manage"},{"key":"10.25259\/IJPC_474_2025\/ref-28","doi-asserted-by":"publisher","first-page":"e0138773","DOI":"10.1371\/journal.pone.0138773","article-title":"The impact of hospice care on survival and healthcare costs for patients with lung cancer: A national longitudinal population-based study in Taiwan","volume":"10","author":"Chiang","year":"2015","journal-title":"PLoS One"},{"key":"10.25259\/IJPC_474_2025\/ref-29","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1089\/jpm.2014.0184","article-title":"Cost savings and enhanced hospice enrollment with a home-based palliative care program implemented as a hospice-private payer partnership","volume":"17","author":"Kerr","year":"2014","journal-title":"J Palliat Med"},{"key":"10.25259\/IJPC_474_2025\/ref-30","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1177\/1049909113499604","article-title":"Utilization and cost of services in the last 6 months of life of patients with cancer-with and without home hospice care","volume":"31","author":"Bentur","year":"2014","journal-title":"Am J Hosp Palliat Care"},{"key":"10.25259\/IJPC_474_2025\/ref-31","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1089\/jpm.2012.0482","article-title":"Hospice offers more palliative care but costs less than usual care for terminal geriatric hepatocellular carcinoma patients: A nationwide study","volume":"16","author":"Hwang","year":"2013","journal-title":"J Palliat Med"},{"key":"10.25259\/IJPC_474_2025\/ref-32","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s00520-010-1047-y","article-title":"Health economics of a palliative care unit for terminal cancer patients: A retrospective cohort study","volume":"20","author":"Jung","year":"2012","journal-title":"Support Care Cancer"},{"key":"10.25259\/IJPC_474_2025\/ref-33","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1089\/jpm.2010.0212","article-title":"Costs of terminal patients who receive palliative care or usual care in different hospital wards","volume":"13","author":"Simoens","year":"2010","journal-title":"J Palliat Med"},{"key":"10.25259\/IJPC_474_2025\/ref-34","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1177\/10499091221098062","article-title":"The financial impact of palliative care and aggressive cancer care on end-of-life health care costs","volume":"40","author":"Davis","year":"2023","journal-title":"Am J Hosp Palliat Care"},{"key":"10.25259\/IJPC_474_2025\/ref-35","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1007\/s00520-025-09193-3","article-title":"Advanced practice nurse-led early palliative care: A novel model for improved access to care","volume":"33","author":"Lelond","year":"2025","journal-title":"Support Care Cancer"},{"key":"10.25259\/IJPC_474_2025\/ref-36","doi-asserted-by":"publisher","first-page":"243","DOI":"10.3390\/diseases12100243","article-title":"Costs of palliative care in oncological and non-oncological patients with different types of ambulatory-based attention: Cost-study protocol","volume":"12","author":"Perea-Bello","year":"2024","journal-title":"Diseases"},{"key":"10.25259\/IJPC_474_2025\/ref-37","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1080\/09699260.2024.2374604","article-title":"Feasibility and economic benefits of community-based palliative care in regional Australia: A case study with cost analysis","volume":"32","author":"Merollini","year":"2024","journal-title":"Prog Palliat Care"},{"key":"10.25259\/IJPC_474_2025\/ref-38","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1111\/hsc.12170","article-title":"Societal costs of home and hospital endof-life care for palliative care patients in Ontario, Canada","volume":"23","author":"Yu","year":"2015","journal-title":"Health Soc Care Community"},{"key":"10.25259\/IJPC_474_2025\/ref-39","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.vhri.2023.07.001","article-title":"Cost-effectiveness of hospice palliative care for patients with cancer and family caregivers: A multicenter study in Kazakhstan","volume":"38","author":"Salikhanov","year":"2023","journal-title":"Value Health Reg Issues"},{"key":"10.25259\/IJPC_474_2025\/ref-40","doi-asserted-by":"publisher","first-page":"2382","DOI":"10.3390\/healthcare11172382","article-title":"Hospice and palliative care during disasters: A systematic review","volume":"11","author":"Plagg","year":"2023","journal-title":"Healthcare (Basel)"},{"key":"10.25259\/IJPC_474_2025\/ref-41","doi-asserted-by":"publisher","first-page":"419","DOI":"10.25259\/IJPC_23_2022","article-title":"Cost analysis on total cost incurred (including out-of-pocket expenditure and social cost) during palliative care in cases of head-and-neck cancer at a government regional cancer centre in North India","volume":"28","author":"Harsvardhan","year":"2022","journal-title":"Indian J Palliat Care"},{"key":"10.25259\/IJPC_474_2025\/ref-42","doi-asserted-by":"publisher","first-page":"e13473","DOI":"10.1111\/ecc.13473","article-title":"Early palliative care associated with lower costs for adults with advanced cancer: Evidence from Hungary","volume":"30","author":"Zempl\u00e9nyi","year":"2021","journal-title":"Eur J Cancer Care (Engl)"},{"key":"10.25259\/IJPC_474_2025\/ref-43","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1001\/archinte.168.16.1783","article-title":"Cost savings associated with US hospital palliative care consultation programs","volume":"168","author":"Morrison","year":"2008","journal-title":"Arch Intern Med"},{"key":"10.25259\/IJPC_474_2025\/ref-44","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1016\/j.jpainsymman.2013.11.017","article-title":"Developing a costing framework for palliative care services","volume":"48","author":"Mosoiu","year":"2014","journal-title":"J Pain Symptom Manage"},{"key":"10.25259\/IJPC_474_2025\/ref-45","doi-asserted-by":"publisher","first-page":"101479","DOI":"10.1016\/j.lanwpc.2025.101479","article-title":"Trends in palliative care utilization among older adult decedents with and without cancer in Taiwan: A population-based comparative study","volume":"55","author":"Lo","year":"2025","journal-title":"Lancet Reg Health West Pac"},{"key":"10.25259\/IJPC_474_2025\/ref-46","doi-asserted-by":"publisher","DOI":"10.3768\/rtipress.2016.rr.0027.1603","article-title":"Financial Considerations of Hospital-Based Palliative Care","author":"Sullender","year":"2016"},{"key":"10.25259\/IJPC_474_2025\/ref-47","doi-asserted-by":"publisher","first-page":"130","DOI":"10.3109\/15360288.2014.911801","article-title":"Strengthening of palliative care as a component of integrated treatment throughout the life course","volume":"28","author":"World Health Organization","year":"2014","journal-title":"J Pain Palliat Care Pharmacother"},{"key":"10.25259\/IJPC_474_2025\/ref-48","doi-asserted-by":"publisher","first-page":"76","DOI":"10.14475\/jhpc.2022.25.2.76","article-title":"Cost-effectiveness analysis of home-based hospice-palliative care for terminal cancer patients","volume":"25","author":"Kim","year":"2022","journal-title":"J Hosp Palliat Care"},{"key":"10.25259\/IJPC_474_2025\/ref-49","doi-asserted-by":"publisher","DOI":"10.1101\/2024.03.06.24303850","article-title":"The Costs and Cost-Effectiveness of Different Service Models of Palliative Care, Focusing on end of Life Care: A Rapid Review [Preprint]","author":"Spencer","year":"2024"},{"key":"10.25259\/IJPC_474_2025\/ref-50","doi-asserted-by":"publisher","first-page":"e5216","DOI":"10.1097\/MD.0000000000005216","article-title":"Medical care utilization and costs on end-of-life cancer patients: The role of hospice care","volume":"95","author":"Chang","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"10.25259\/IJPC_474_2025\/ref-51","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s12904-020-0526-2","article-title":"A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admissions and bed days in people nearing the end of their life: Much innovation, but limited supporting evidence","volume":"19","author":"Taylor","year":"2020","journal-title":"BMC Palliat Care"},{"key":"10.25259\/IJPC_474_2025\/ref-52","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1177\/0269216316670287","article-title":"What cost components are relevant for economic evaluations of palliative care, and what approaches are used to measure these costs? A systematic review","volume":"31","author":"Gardiner","year":"2017","journal-title":"Palliat Med"},{"key":"10.25259\/IJPC_474_2025\/ref-53","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1089\/pmr.2020.0023","article-title":"Hospice or hospital: The costs of dying of cancer in the oncology care model","volume":"1","author":"Hoverman","year":"2020","journal-title":"Palliat Med Rep"}],"container-title":["Indian Journal of Palliative Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jpalliativecare.com\/medical-costs-of-palliative-and-hospice-care-versus-usual-care-in-terminal-cancer-a-systematic-review-and-meta-analysis\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jpalliativecare.com\/medical-costs-of-palliative-and-hospice-care-versus-usual-care-in-terminal-cancer-a-systematic-review-and-meta-analysis\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T14:41:35Z","timestamp":1788273695000},"score":1,"resource":{"primary":{"URL":"https:\/\/jpalliativecare.com\/medical-costs-of-palliative-and-hospice-care-versus-usual-care-in-terminal-cancer-a-systematic-review-and-meta-analysis\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":53,"alternative-id":["10.25259\/IJPC_474_2025"],"URL":"https:\/\/doi.org\/10.25259\/ijpc_474_2025","relation":{},"ISSN":["1998-3735","0973-1075"],"issn-type":[{"value":"1998-3735","type":"electronic"},{"value":"0973-1075","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"article-number":"255"}}