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Exploring the cost-effectiveness of advance care planning (by taking a family carer perspective): findings of an economic modelling study

Bauer, Annette ORCID: 0000-0001-5156-1631, Dixon, Josie ORCID: 0000-0003-4772-6450, Knapp, Martin ORCID: 0000-0003-1427-0215 and Wittenberg, Raphael ORCID: 0000-0003-3096-2721 (2021) Exploring the cost-effectiveness of advance care planning (by taking a family carer perspective): findings of an economic modelling study. Health and Social Care in the Community, 29 (4). 967 - 981. ISSN 0966-0410

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Identification Number: 10.1111/hsc.13131


Advance care planning is considered an important part of high-quality end-of-life care. Its cost-effectiveness is currently unknown. In this study, we explore the cost-effectiveness of a strategy, in which advance care planning is offered systematically to older people at the end-of-life compared with standard care. We conducted decision-analytic modelling. The perspective was health and social care and the time horizon was 1 year. Outcomes included were quality-adjusted life years as they referred to the surviving carers. Data sources included published studies, national statistics and expert views. Average total cost in the advance care planning versus standard care group was £3,739 versus £3,069. The quality-adjusted life year gain to carers was 0.03 for the intervention in comparison with the standard care group. Based on carer's health-related quality-of-life, the average cost per quality-adjusted life year was £18,965. The probability that the intervention was cost-effective was 55% (70%) at a cost per quality-adjusted life year threshold of £20,000 (£30,000). Conducting cost-effectiveness analysis for advance care planning is challenging due to uncertainties in practice and research, such as a lack of agreement on how advance care planning should be provided and by whom (which influences its costs), and about relevant beneficiary groups (which influences its outcomes). However, even when assuming relatively high costs for the delivery of advance care planning and only one beneficiary group, namely, family carers, our analysis showed that advance care planning was probably cost-effective.

Item Type: Article
Official URL:
Additional Information: © 2020 The Authors
Divisions: Personal Social Services Research Unit
Health Policy
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 03 Aug 2020 08:24
Last Modified: 17 Apr 2024 01:15

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