Optimizing Decision Making and Resource Allocation in Palliative Care

Optimizing resource allocation in end-of-life care is one of the most difficult issues currently being addressed within the U.K. National Health Service. Decision rules and cost-effectiveness thresholds that would appear to be appropriate for acute interventions may significantly undervalue extensions in quantity and quality of life provided to the terminally ill. Arguably, the value placed on improving quantity and quality of life is dependent on the context in which they are derived. In such circumstances, we can either adjust cost-effectiveness thresholds to ensure that end-of-life interventions have a less stringent cost-effectiveness hurdle to overcome or we can derive an entirely new evaluative framework that better captures the true value of interventions focusing primarily on care rather than cure. Irrespective of the approach taken, optimizing resource allocation in palliative care is crucial in ensuring that overall therapeutic objectives both for individual patients and for this patient group as a whole are achieved to the greatest degree possible.