Resource use and costs of end-of-life/palliative care: Ontario adult cancer patients dying during 2002 and 2003

The objective of this study is to estimate the direct medical cost of end-of-life and palliative (EOL/PAL) care for cancer patients during the last six months of their lives–or, during the period from diagnosis to death, if briefer–in 2002 and 2003, in Ontario, Canada. A linkage of cancer registry and administrative data is used to determine the costs of healthcare resources used during the EOL/PAL care period. Costs are analyzed by cancer diagnosis, location of death, and type of service. The total Ontario Ministry of Health-funded cost of EOL/PAL care for cancer patients is estimated to be about CAD$544 million per year, with an average per patient cost of about $25,000 in 2002-2003. Results suggest that acute care consumes 75 percent of EOL/PAL funding and that only a small proportion of healthcare services used by EOL/PAL care cancer patients is likely to be formal palliative care.