Economic and Clinical Impact of a Consultative Palliative Care Model for Patients with Cancer in Palestine Mohamad Khleif* AL-Sadeel Society for Palliative Care, Palestine Abstract Healthcare decisions demand evidence on cost-effectiveness, which is not well established for hospital- based palliative care (PC) consultative model for inpatients with cancer. Full economic evaluation, using cost-utility analysis, over one-year follow-up of 195 patients, was used to determine this in Palestine. Aim was to assess the clinical and economic impact of this model by comparing PC with standard care (SC) groups. Utility and cost data were collected at each admission and analyzed statistically and economically. Very low quality of life (QoL) in general (PC=59%, SC=45%; p<0.01), better QoL at discharge (PC=71%, SC=49.5%; p<0.01), and improved longitudinal effects of the PC consultations for PC group (β from 9.3% to25.4%) were found in the cancer patients. Other predictors of poor QoL were stage four of cancer (β= -9.3%) and hospitalization for symptoms control (β= -19%). The difference in mean costs between the two groups was not statistically significant (PC=22,332 NIS, SC=22,410 NIS; p=0.71), however, the difference in mean QALYs was highly statistically significant (PC=0.8199, SC=0.7513; p<0.0001). The main cost drivers were the costs of chemotherapy and length-of- stay, which were higher in the SC patients. Decision-tree analysis promoted PC as the dominant strategy with negative ICUR value for the base-case analysis. Sensitivity analysis revealed a robust enough decision with either dominant or cost-effective ratios. Ultimately, PC consultation team for in-patients was able to demonstrate improved outcomes of care and save costs for the healthcare system. Adoption of this cost- effective strategy by policy makers would appear to be wise use of public funds. Keywords: Economic evaluation; Palliative care; Palestine; Cost effectiveness; Cost utility analysis; Cancer; Quality of life Background In healthcare services, the debate centers on costs, as these services deplete scarce resources in providing quality care to patients and their families in order to improve their quality of life (QoL). This forces decision makers to look for efficiency and effectiveness, and to compare between competing alternatives of care based on evidence-based evaluation, which is not well established in many areas such as palliative care (PC), especially in developing countries [1]. When considering cancer care, these constrains are at the highest. Cancer is one of the leading causes of death both worldwide [2], and the second in Palestine accounting for 14% of all deaths [3], where most cases are diagnosed at the end stage of the disease [4,5]. Moreover, cancer incidence in Middle Eastern countries is predicted to increase by 70% in the next 20 years [6], as well as a significant need for PC service in the Middle East region, including Palestine [7]. The literature suggests that specialist inpatient PC services can significantly reduce healthcare costs and improve patient outcomes [8,9]. Conversely, there have been very few economic reviews focused on specialist hospital inpatient PC consultation and comparing costs within patient outcomes, with limited evidence from a prospective design [10,11]. This has not been studied in Palestine, nor in the region or in the Arab countries. This study explored such model of care and its effects on the clinical and economic outcomes of care for cancer patients, looking for level of evidence for the cost effectiveness of PC to be sufficient to support advocacy and lobbying toward initiation and integration of PC services into the healthcare system. Methodology The study adapted a one-year prospective observational analytic cohort design to study costs and clinical outcomes of care for patients with cancer at Beit Jala governmental hospital; Crimson Publishers Wings to the Research Mini Review *Corresponding author: Mohamad HK, AL-Sadeel Society for Palliative Care, Beth- lehem, Palestine Submission: February 25, 2020 Published: March 05, 2020 Volume 6 - Issue 1 How to cite this article: Mohamad Kh- leif. Economic and Clinical Impact of a Consultative Palliative Care Model for Pa- tients with Cancer in Palestine. COJ Nurse Healthcare.6(1). COJNH.000629.2020. DOI: 10.31031/COJNH.2020.06.000629. Copyright@ Mohamad Khleif, This article is distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited. ISSN: 2577-2007 579 COJ Nursing & Healthcare