UICC World Cancer Congress 2006

Objective: Audit costs at the end of life. Introduction: lack of a palliative approach leads to treatments which do not respond to patient expectations.

Methods:retrospective study of 50 medical records of cancer patients (6 month period). Patients were regrouped according to stages: progressive, advanced, terminal; these items were recorded: time of stay, number of hospitalizations and emergency admissions, total hospitalization costs, laboratory tests, diagnostic imaging. The results are expressed in units of relative value (UVR from its initials in Spanish), one UVR corresponding to the minimal value entered in the data base. For comparison purposes, the minimal salary in Colombia corresponds to 2UVRs.

Results:Results: 58% were at the progressive or advanced stage; terminal stage 42%; average hospital stay during the last hospitalization: 11 days; 16% stayed >hospitalized 2 months; 12% reported > 8 admissions; 14% recorded 6-13 emergency admissions; 71% not assessed by the pain clinic. The total cost for assistance: 9,893 UVR; the highest costs came up at the progressive stage: 6,238 UVR; at the terminal stage: 2,356 UVR. The cost of diagnostic and laboratory tests for the terminal group was 3 UVR and 4 UVR respectively; 37.76% of the resources were invested at the terminal stage Conclusions: Research shows the need to improve the quality of assistance by the development of palliative care; goals include the request for more referrals to the pain group, reduction in the number of hospitalized patients; the establishment of guidelines on the pertinence of clinical exams on terminal patients.