Medical Costs of Palliative and Hospice Care versus Usual Care in Terminal Cancer: A Systematic Review and Meta-Analysis

Vollständiger Abstract

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To evaluate medical costs associated with palliative care (PC) and hospice care (HC) compared with usual care among patients with terminal cancer, while accounting for variations in cost definitions and models of care. A systematic review and meta-analysis of observational studies were conducted. Literature searches were performed in PubMed, Scopus, and ProQuest (January 2010–July 2025). Eligible studies compared the medical costs of palliative or hospice care with usual care in adult terminal cancer patients. Care models were defined according to study-specific criteria. Data were pooled using a random-effects meta-analysis, and heterogeneity was assessed using the I 2 statistic. Eighteen studies were included. PC was associated with lower medical costs than usual care (standardised mean difference [SMD] −0.31; 95% confidence interval [CI] −0.35–−0.27; p < 0.00001), while HC showed greater cost reductions (SMD −0.64; 95% CI −0.67–−0.62; p < 0.00001). The overall pooled effect favoured palliative-oriented models (SMD −0.54; 95% CI −0.57– −0.52). However, substantial heterogeneity (I 2 up to 100%) likely reflects differences in cost components, care models and health system contexts. PC and HC reduce medical costs and support integration into routine oncology and end-of-life care.