Economic outcomes of palliative care in colorectal cancer hospitalizations: A propensity-matched retrospective cohort study on resource utilization.

Abstract

12098 Background: The economic burden of colorectal cancer (CRC), a major cause of cancer-related death worldwide, is significant and is fueled by extended hospital stays, intensive treatments, and expensive end-of-life care, with costs expected to rise as the population ages. While clinical research has established the benefits of palliative care (PC) in improving patient outcomes, its economic impact within CRC care pathways remains underexplored. This study employs a large-scale, propensity-matched cohort analysis to evaluate the economic burden of PC integration during CRC hospitalization, addressing knowledge regarding the impact of early palliative interventions on healthcare expenditures and resource utilization. Methods: Utilizing data from the Global Collaborative Network-TriNetX, this retrospective cohort analysis evaluated the economic ramifications of early palliative care integration in adults (≥18 years) hospitalized with colorectal cancer. Using ICD-10 codes, we identified patients with malignant colorectal neoplasms, stratifying them into two cohorts: Cohort 1 (n=14,430) comprised individuals receiving palliative care within one month of diagnosis, while Cohort 2 (n=752,405) included those without palliative care exposure. Cohorts were balanced across sociodemographic and clinical variables via propensity score matching. Outcomes using surrogates for healthcare resource utilization and economic burden (inpatient, emergency department, and outpatient visits) were assessed over a 10-year follow-up period (beginning one day post-diagnosis). Results are reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Following propensity score matching, two balanced cohorts (n=13,991 each) were established, with comparable baseline characteristics. The palliative care cohort had a mean age of 75.8 years, predominantly white—58.7%—and 54.3% males and 45.7% females—while the non-palliative care cohort averaged 76.3 years, predominantly white—59.8%—53.8% males and 46.2% females. Compared to the non-palliative care cohort, the palliative care cohort demonstrated significantly lower risks of inpatient admissions (OR 0.371; 95% CI 0.333–0.413; p < 0.001), emergency department visits (OR 0.342; 95% CI 0.311–0.377; p < 0.001), and outpatient visits (OR 0.397; 95% CI 0.357–0.441; p < 0.001). Conclusions: Our study found that early integration of palliative care (PC) in colorectal cancer (CRC) hospitalizations is associated with significant cost savings, achieved through reduced utilization of resource-intensive services, including inpatient, outpatient, and emergency department admissions. These findings suggest that PC could have a positive impact on financial sustainability and end-of-life quality while alleviating the economic burden on healthcare systems and individuals.