Caring for People at the End of Life: A Health Economist’s Perspective

24 October 2018
Edmonton, Alberta

As people approach the end of their lives, many will require specialist end-of-life and palliative care. Such care aims to ‘help those with advanced, progressive, incurable illness to live as well as possible until they die’ and includes the management of pain and other symptoms, and provision of psychological, social, spiritual and practical support’. Over 250,000 people in Canada died in 2016, and it is estimated that up to 75% of people will have palliative care needs prior to death. Yet just 1/3 of people in Canada had access to palliative care. In 2017, the Canadian government launched a consultation aimed at increasing access to, and improving the quality of, palliative care services. The outcome of the review is likely to place greater demands on health services to provide cost-effective palliative care. It will also lead to greater demand on economists to understand how to assess the value of palliative and end-of-life care services. 

It has been argued that end-of-life care should be considered a special case within economic evaluation, with different methods used and different values placed on outcomes. In this session I will discuss the actual and perceived challenges of undertaking economic evaluations within end-of-life care research. I will explore arguments about what methods we should use, including questions of what outcomes to measure (and in whom), how to evaluate the complex interventions that typify much end-of-life care, and I will highlight problems associated with missing data in palliative and end-of-life care research. I will also explore questions about societal preferences in relation to end-of-life care provision, including whether and how end-of-life care is seen as special case by policy makers and the public, and what the empirical evidence tells us about how to value care at the end of life.

Caring for People at the End of Life: A Health Economist’s Perspective


Jeff Round Profile PictureJeff Round is a Senior Health Economist at the Institute of Health Economics. Jeff specializes in decision analytic modelling and HTA, and his research encompasses both applied and methodological topics in health economics and economic evaluation. In recent years his research has focused on topics related to end of life and palliative care. A recent paper on the societal costs of providing care at the end of life was recognized as the Research Paper of the Year for 2015 in the journal Palliative Medicine, and in 2016, he published an edited book, Care at the End of Life: An Economic Perspective.

The Network of Alberta Health Economists and the NOAHE Health Economics and Technology Assessment Rounds are supported financially and in-kind by Alberta Health, through the Health Funding and Economics Capacity (HFEC) Grant. Please note that the views expressed in this series and other deliverables associated with NOAHE are not necessarily representative of any particular organization involved.