Dying well at home: the case for integrated working

Costs of dying at home

The economic impact of people dying at home

Reducing reliance on acute care could release resources and better meet people’s preferences.

Health economist [3]


  • The NHS should have a better evidence-based understanding of the relative costs of specialist and generalist care at the end of life, analysed according to place of care delivery.
  • Time spent in hospital in the last year of life is the most expensive factor in end of life care. Policy makers and commissioners should concentrate on interventions to keep people out of hospital if they do not need to be there, and to discharge them as early as possible.
  • Economic analyses should reflect the ‘cost’ to family members of caring, and should consider how savings to the state can be harnessed to support carers to continue to care at home.

Key points from research and policy

Difficulties with costing

Potential for cost savings

Practice example

  • Practice example 8. An economic and qualitative evaluation of the Midhurst Macmillan Specialist Palliative Care Service suggests that the service is cost-effective as well as offering maximum choice to people at the end of life.


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  • Dying well at home: the case for integrated working
  • Dying well at home: research evidence