Rationale: People with complex medical illness are the most significant challenge facing 21st century healthcare. Palliative care (PC) aims to improve outcomes for seriously-ill people through interdisciplinary, patient-centred decision-making. Current policy suggests that Ireland could be the first country to legislate for universal PC provision on the basis of need. Economic evidence on policy options is limited.
Aims and objectives: The primary aim of this study is to estimate the costs of national universal PC provision and compare these with current provision.
This aim will be achieved through:
Analysis of cohort study data from Ireland and internationally to improve understanding of when and for whom PC impacts patterns of care [Work packages 1-3];
Econometric modelling to estimate and compare costs (societal perspective) of current and proposed policy options, 2021-2046 [Work package 4].
Methods and data: Cohort study analysis incorporates multiple available datasets. Associations between PC and costs will be evaluated using nonlinear models, segmenting samples by baseline characteristics. Then a demographic and economic simulation model will be developed, estimating the societal costs of universal provision and comparing this to current provision. Estimates will take into account health states and utilisation among older people in Ireland with PC needs, changing needs due to demographic ageing, the cost of universal provision, and estimates of how universal provision would impact costs overall. Data will be drawn from a sub-sample of older adults with PC need in The Irish Longitudinal study on Ageing (TILDA).
Output: The primary output will be a report estimating the cost-effects to Ireland of implementing universal PC provision on the basis of need (compared to not doing so and retaining current provision). This proposal has been devised in consultation with the Department of Health and would feed directly into current policymaking.
