Health services costs for lung cancer care in Australia: Estimates from the 45 and Up Study

  • 26 October 2020
  • Author: CareSearch
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Goldsbury DE, Weber MF, Yap S, Rankin NM, Ngo P, Veerman L, Banks E, Canfell K, O'Connell DL.

Background:
Of all cancer types, healthcare for lung cancer is the third most costly in Australia, but there is little detailed information about these costs. Our aim was to provide detailed population-based estimates of health system costs for lung cancer care, as a benchmark prior to wider availability of targeted therapies/immunotherapy and to inform cost-effectiveness analyses of lung cancer screening and other interventions in Australia.

Methods:
Health system costs were estimated for incident lung cancers in the Australian 45 and Up Study cohort, diagnosed between recruitment (2006-2009) and 2013. Costs to June 2016 included services reimbursed via the Medicare Benefits Schedule, medicines reimbursed via the Pharmaceutical Benefits Scheme, inpatient hospitalisations, and emergency department presentations. Costs for cases and matched, cancer-free controls were compared to derive excess costs of care. Costs were disaggregated by patient and tumour characteristics. Data for more recent cases identified in hospital records provided preliminary information on targeted therapy/immunotherapy.

Results:
994 eligible cases were diagnosed with lung cancer 2006-2013; 51% and 74% died within one and three years respectively. Excess costs from one-year pre-diagnosis to three years post-diagnosis averaged ~$51,900 per case. Observed costs were higher for cases diagnosed at age 45-59 ($67,700) or 60-69 ($63,500), and lower for cases aged ≥80 ($29,500) and those with unspecified histology ($31,700) or unknown stage ($36,500). Factors associated with lower costs generally related to shorter survival: older age (p<0.0001), smoking (p<0.0001) and unknown stage (p = 0.002). There was no evidence of differences by year of diagnosis or sex (both p>0.50). For 465 cases diagnosed 2014-2015, 29% had subsidised molecular testing for targeted therapy/immunotherapy and 4% had subsidised targeted therapies.

Conclusions:
Lung cancer healthcare costs are strongly associated with survival-related factors. Costs appeared stable over the period 2006-2013. This study provides a framework for evaluating the health/economic impact of introducing lung cancer screening and other interventions in Australia.

Implementation Plan for the National Palliative Care Strategy 2018

  • 23 October 2020
  • Author: CareSearch
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On October 20, the Department of Health have released their Implementation Plan for the National Palliative Care Strategy 2018. Key to the plan are four action areas:

  1. Access to palliative care is increased, particularly for underserved populations.
  2. The collaboration and coordination of palliative care is improved.
  3. Advance care plans are being prepared by people affected by life limiting illnesses and used to facilitate shared decision-making across care settings.
  4. Nationally consistent data collection mechanisms are implemented and national public reporting is underway.

You can download the plan from the Department website.

New publications from the Royal Commission into Aged Care Quality and Safety

  • 23 October 2020
  • Author: CareSearch
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On October 22nd at the final hearing of the Royal Commission into Aged Care Quality and Safety, findings were handed down by the Counsel Assisting team for the consideration of the Commissioners, and for any response by interested parties.

The documents containing 124 recommendations including in relation to palliative care are now available from the website:

The Commission has also released two new research papers prepared by National Ageing Research Institute (NARI) :

The Development of the Australian National Palliative Care Clinical Studies Collaborative "Integrating Qualitative Research into Clinical Trials Framework"

  • 23 October 2020
  • Author: CareSearch
  • Number of views: 0
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Philip J, Collins A, Phillips J, Luckett T, Morgan DD, Lobb EA, DiGiacomo M, Kochovska S, Brown L, Currow DC.

Qualitative methodologies have multiple contributions to health research, including improving baseline understanding in new areas of enquiry; questioning existing assumptions; understanding viewpoints of specific subgroups; and offering complex, contextual information. While the role of qualitative research within mixed methods approaches is well documented, the contribution to clinical trial design and conduct is less well recognized. The Australian Palliative Care Clinical Studies Collaborative and Cancer Symptom Trials have developed a framework to detail how qualitative research might contribute to each key aspect of clinical trials. This practical framework provides real-world examples, including sample qualitative questions, to consider at each phase of controlled clinical trial development. As the number of randomized clinical trials in palliative care increases, a readily accessible approach to integrating qualitative research into clinical trial design and conduct is needed so that its full potential for improving study recruitment, conduct, outcomes, interpretation, and implementation may be realized.

Death is a part of life - the core of End-of-Life Essentials

A guest blog post by Associate Professor Kim Devery, Project Lead and Ms Deb Rawlings, Co-Lead, End-of-Life Essentials

  • 22 October 2020
  • Author: Guest
  • Number of views: 914
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Death is a part of life - the core of End-of-Life Essentials

In the sixth blog for our National Palliative Care Project series Associate Professor Kim Devery, Project Lead and Ms Deb Rawlings, Co-Lead of End-of-Life Essentials (EOLE) discuss how the EOLE project will help nurses, doctors and allied health professionals to improve the quality of end-of-life care in hospitals around Australia through their free online education and training modules.

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