Table 1 Palliative care: A high value proposition where value = patient outcomes achieved relative to cost [11]

Patient benefits: Randomized control trials involving more than 2500 patients with advanced cancer demonstrate improved QOL, symptoms, mood, communication, satisfaction with care & survival [12,13,14,15,16,17,18,19,20,21].

Family carer benefits: Evidence demonstrates improved health outcomes, mood, and satisfaction and survival [17, 22]

Health Service Benefits: Earlier palliative care referrals are associated with 70% greater likelihood of death outside hospital - the preferred option of most patients [23], fewer emergency presentations (48% vs 68%; P < .001), & hospital admissions (52% vs 86%; P < .001) [24, 25].

Reduced cost: Evidence from systematic reviews report costs savings of $4251 per patient and simultaneous improvement of quality of care [26]

Timing of palliative care is important to realise benefits: incremental advantages according to length of engagement with palliative care; > 2 weeks before death associated with reduced hospital death (P < 0.001), more than 4 weeks with fewer emergency presentations (≥4 weeks, P < 0.001) [24]. Expert consensus suggests referral should occur ≥3 months before death [27].