The importance of following the money in the development and sustainability of palliative care

1. J Brian Cassel

1. Division of Hematology, Oncology and Palliative Care, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA

1. J Brian Cassel Division of Hematology, Oncology and Palliative Care, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, 23298-0037, USA. Email: jbcassel@vcu.edu

Questions about cost-effectiveness and efficiency of health care are universal across developed economies, regardless of the underlying political economy of a given country or the financing of its health-care system. The articles from Klinger et al.,¹ regarding home-based palliative care in rural Ontario, and from Roberts and Hurst,² regarding inpatient palliative care unit staffing in England, are two cases in point. As our field continues to mature and develop, we can expect to see more of such studies taking place worldwide, because they shed much-needed light on management and sustainability issues in specialist palliative care. 

The study from Roberts and Hurst makes salient the point that sustainability in our field involves not only monetary inputs (resources, represented as costs) but also workforce availability. Availability is influenced by many factors across the world, including funding for specialist education and training, as well as issues of satisfaction, burnout, and turnover among specialist staff. 

The study from Klinger et al. goes beyond a snapshot of current practices and attempts projections of what future, broader utilization could look like. This is an important issue in countries such as Canada and the United Kingdom where …

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