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Dr. Peter May
Research Assistant Professor, Public Health & Primary Care

Biography

Economist focusing on care for people with serious medical illness and complex needs. I design, run and analyse evaluations of interventions for patients and their families. In addition to our studies in Ireland, I collaborate extensively with research groups in the United Kingdom, the United States, Europe and elsewhere.

Publications and Further Research Outputs

Peer-Reviewed Publications

May P, Normand C, Morrison RS., Economics of Palliative Care for Cancer: Interpreting Current Evidence, Mapping Future Priorities for Research., Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2020, pJCO1802294 Journal Article, 2020 DOI

May P, Johnston BM, Normand C, Higginson IJ, Kenny RA, Ryan K, Population-based palliative care planning in Ireland: how many people will live and die with serious illness to 2046?, HRB Open Research, 2, 2020, p35 Journal Article, 2020 DOI

May P, Roe L, McGarrigle CA, Kenny RA, Normand C., End-of-life experience for older adults in Ireland: results from the Irish longitudinal study on ageing (TILDA)., BMC health services research, 20, (1), 2020, p118 Journal Article, 2020 DOI

Johnston BM, McCauley R, May P, Rabbitte M, McQuillan R, Honohan C, Mockler D, Thomas S, Out-of-hours specialist and generalist palliative care service provision: A review of models and evidence, European Association of Palliative Care, Berlin, Germany, May 2019, 2019 Poster, 2019 URL

May P, Normand C, Del Fabbro E, Fine RL, Morrison RS, Ottewill I, Robinson C, Cassel JB., Economic Analysis of Hospital Palliative Care: Investigating Heterogeneity by Noncancer Diagnoses., MDM Policy Pract, 4, (2), 2019, p2381468319866451 Journal Article, 2019 DOI

Financial Aspects of Inpatient Palliative Care in, editor(s)Van den Block L, McLeod R , Textbook on Palliative Care, Springer, 2019, [May P, Morrison RS] Book Chapter, 2019 DOI

Johnston BM, May P, McCauley R, Rabbitte M, McQuillan R, Honohan C, Mockler D, Thomas S, Out-of-hours specialist and generalist palliative care service provision: An evidence review, Dublin, Ireland, 2019 Report, 2019 URL

Tiernan E, Ryan J, Casey M, Hale A, O'Reilly V, Devenish M, Whyte B, Hollingsworth S, Price O, Callanan I, Walsh D, Normand C, May P., A quasi-experimental evaluation of an intervention to increase palliative medicine referral in the emergency department., Journal of health services research & policy, 24, (3), 2019, p155-163 Journal Article, 2019 DOI

BMC Health Services Research, BioMed Central, [Associate Editor], 2019 Editorial Board, 2019

Storick V, O'Herlihy A, Abdelhafeez S, Ahmed R, May P, Improving palliative care with machine learning and routine data: a rapid review , HRB Open Research, 2019 Journal Article, 2019 DOI TARA - Full Text

Measuring Cost-Effectiveness in Palliative Care in, editor(s)Van den Block L, McLeod R , Textbook on Palliative Care, Springer, 2019, [Normand C, May P] Book Chapter, 2019 Other

McCarron M, Lombard-Vance R, Murphy E, May P, Webb N, Sheaf G, McCallion P, Stancliffe R, Normand C, Smith V, O'Donovan MA, Effect of deinstitutionalisation on quality of life for adults with intellectual disabilities: a systematic review, BMJ Open, 2019 Journal Article, 2019 DOI TARA - Full Text

May P, Lombard Vance R, Murphy E, O'Donovan MA, Webb N, Sheaf G, McCallion P, Stancliffe R, Normand C, Smith V, McCarron M., Effect of deinstitutionalisation for adults with intellectual disabilities on costs: a systematic review., BMJ Open, 9, (9), 2019, pe025736 Journal Article, 2019 DOI

May P, Johnston BM, Higginson IJ, Normand C, Ryan K, Future palliative care needs for people living and dying with life-limiting illness: results from Ireland, European Association of Palliative Care, Berlin, Germany, May 2019, 2019 Poster, 2019 URL

May P, Garrido MM, Del Fabbro E, Noreika D, Normand C, Skoro N, Cassel JB., Evaluating Hospital Readmissions for Persons With Serious and Complex Illness: A Competing Risks Approach., Medical care research and review : MCRR, 2019, p1077558718823919 Journal Article, 2019 DOI

Khandelwal N, May P, Curtis JR., Financial stress after critical illness: an unintended consequence of high-intensity care., Intensive care medicine, 2019 Journal Article, 2019 DOI

May P, High costs of end-of-life care: an alternative economic perspective, International Health Economics Association, Basel, Switzerland, July 2019, 2019 Conference Paper, 2019 URL

May P, Normand C, Patterns and Determinants of Healthcare Use in the Last Year of Life among Older Adults in Ireland: Results from The Irish LongiDinal Study on Ageing (TILDA), EAPC Research Congress, Bern, Switzerland, May, 2018 Conference Paper, 2018 DOI

Cassel JB, Normand C, Garrido MM, Del Fabbro E, Noreika D, Skoro N, May P, Impact of Specialist Palliative Care on Hospital Readmissions: A "Competing Risks" Analysis to Take Mortality into Account, American Academy of Hospice and Palliative Medicine, Boston, MA, March, 2018 Conference Paper, 2018 URL

Chang S, May P, Goldstein NE, Wisnivesky J, Rosenzweig K, Morrison RS, Dharmarajan KV., A Palliative Radiation Oncology Consult Service's Impact on Care of Advanced Cancer Patients., Journal of palliative medicine, 21, (4), 2018, p438 - 444 Journal Article, 2018 DOI

May P, Garrido MM, Del Fabbro E, Noreika D, Normand C, Skoro N, Cassel JB, Does modality matter? Palliative care units associated with more cost-avoidance than consultations., Journal of Pain and Symptom Management, 55, (3), 2018, p766 - 774 Journal Article, 2018 DOI

Chang S, May P, Goldstein NE, Wisnivesky J, Ricks D, Fuld D, Aldridge M, Rosenzweig K, Morrison RS, Dharmarajan KV, A Palliative Radiation Oncology Consult Service Reduces Total Costs During Hospitalization., Journal of pain and symptom management, 2018 Journal Article, 2018 DOI

McCarron M, Lombard-Vance R, Murphy E, O'Donovan MA, Webb N, Sheaf G, McCallion P, Stancliffe R, Normand C, Smith V, May P, Quality of life outcomes and costs associated with moving from congregated settings to community living arrangements for people with intellectual disability: An evidence review, Dublin, Health Research Board, September, 2018, 94 Report, 2018 URL

May P, Normand C, Cassel JB, Del Fabbro E, Fine RL, Menz R, Morrison CA, Penrod JD, Robinson C, Morrison RS., Economics of Palliative Care for Hospitalized Adults With Serious Illness: A Meta-analysis., JAMA internal medicine, 2018 Journal Article, 2018 DOI

Cassel JB, Normand C, Garrido MM, Del Fabbro E, Noreika D, Skoro N, May P, Impact of Specialist Palliative Care on Hospital Readmissions: A "Competing Risks" Analysis to Take Mortality into Account, EAPC Research Congress, Bern, Switzerland, May, 2018 Conference Paper, 2018 DOI

May P, Cassel JB, Economic outcomes in palliative and end-of-life care: current state of affairs, Ann Palliat Med, 7, ((Suppl 3)), 2018, pS244 - S248 Journal Article, 2018 DOI

May P, Normand C, Morrison RS, Economics of palliative care for hospital inpatients with serious illness: Meta analysis of current evidence, Academy Health ARM, New Orleans, LA, June, 2017 Conference Paper, 2017 URL

May P, Morrison RS, Murtagh FE., Current state of the economics of palliative and end-of-life care: A clinical view., Palliative medicine, 31, (4), 2017, p293-295 Journal Article, 2017 DOI

May P, Garrido MM, Aldridge MD, Cassel JB, Kelley AS, Meier DE, Normand C, Penrod JD, Smith TJ, Morrison RS., Prospective Cohort Study of Hospitalized Adults With Advanced Cancer: Associations Between Complications, Comorbidity, and Utilization., Journal of hospital medicine, 12, (6), 2017, p407-413 Journal Article, 2017 DOI

May P, Garrido MM, Cassel JB, Kelley AS, Meier DE, Normand C, Smith TJ, Morrison RS., Cost analysis of a prospective multi-site cohort study of palliative care consultation teams for adults with advanced cancer: Where do cost-savings come from?, Palliative medicine, 31, (4), 2017, p378-386 Journal Article, 2017 DOI

May P, Normand C, Morrison RS, Economics of palliative care for hospital inpatients with serious illness: Meta analysis of current evidence, iHEA Congress, Boston, MA, July, 2017 Conference Paper, 2017 URL

Penrod JD, Garrido MM, McKendrick K, May P, Aldridge MD, Meier DE, Ornstein KA, Morrison RS., Characteristics of Hospitalized Cancer Patients Referred for Inpatient Palliative Care Consultation., Journal of palliative medicine, 2017 Journal Article, 2017 DOI

May P, Normand C, Analyzing the Impact of Palliative Care Interventions on Cost of Hospitalization: Practical Guidance for Choice of Dependent Variable., Journal of pain and symptom management, 52, (1), 2016, p100 - 106 Journal Article, 2016 DOI

May P, Garrido MM, Cassel JB, Morrison RS, Normand C, Using Length of Stay to Control for Unobserved Heterogeneity When Estimating Treatment Effect on Hospital Costs with Observational Data: Issues of Reliability, Robustness, and Usefulness., Health services research, 51, (5), 2016, p2020 - 2043 Journal Article, 2016 DOI

May P, Morrison RS, Normand C, Meta analysis: association between palliative care consultation teams and costs for hospitalized adults, European Association of Palliative Care, Dublin, Ireland, June , 2016 Poster, 2016 URL

May P, Morrison RS, Normand C, Meta analysis: association between palliative care consultation teams and costs for hospitalized adults, Academy Health, Boston, MA, June , 2016 Poster, 2016 URL

May P, Garrido MM, Cassel JB, Kelley AS, Meier DE, Normand C, Stefanis L, Smith TJ, Morrison RS, Palliative Care Teams' Cost-Saving Effect Is Larger For Cancer Patients With Higher Numbers Of Comorbidities., Health affairs (Project Hope), 35, (1), 2016, p44-53 Journal Article, 2016 DOI

Johnston BM, Normand C, May P., Economics of Palliative Care: Measuring the Full Value of an Intervention, Journal of Palliative Medicine, 2016 Journal Article, 2016 DOI

May P, Garrido MM, Cassel JB, Kelley AS, Meier DE, Normand C, Smith TJ, Stefanis L, Morrison RS, Prospective Cohort Study of Hospital Palliative Care Teams for Inpatients With Advanced Cancer: Earlier Consultation Is Associated With Larger Cost-Saving Effect, Journal of Clinical Oncology, 33, (25), 2015, p2745 - 2752 Journal Article, 2015 DOI

May P, Garrido MM, Cassel JB, et al. , Economics of PCCTs: heterogeneity of treatment effects, American Academy for Hospice and Palliative Medicine, Philadelphia, PA, February, 2015 Conference Paper, 2015 URL

May P, Garrido MM, Cassel JB, et al. , Economic Evaluation of PCCTs for Hospitalised Patients with Advanced Cancer, EAPC World Congress, Copenhagen, Denmark, May, 2015 Conference Paper, 2015 URL

May, P., Normand, C. & Morrison, R. S. , Economic impact of hospital inpatient palliative care consultation: review of current evidence and directions for future research. , Journal of Palliative Medicine, 17, (9), 2014, p1054-63 Journal Article, 2014 DOI TARA - Full Text

May P, Normand C, Morrison RS, Economic evaluation of specialist inpatient palliative care consultation teams, EAPC Research Congress, Lleida, Spain, June, 2014 Conference Paper, 2014 URL

May P, Normand C, Morrison RS, Economic evaluation of specialist inpatient palliative care consultation teams, iHEA Congress, Dublin, Ireland, July, 2014 Conference Paper, 2014 URL

May, P., Hynes, G., McCallion, P., Payne, S., Larkin, P., McCarron, M, Policy analysis: Palliative care in Ireland, Health Policy, 115, (1), 2014, p68 - 74 Journal Article, 2014 DOI TARA - Full Text

May P, Hynes G, McCallion P, Payne S, Higgins A, Larkin P, McCarron, M, Challenges in increasing regional equity in palliative care service provision in Ireland , European Journal of Palliative Care, 20, (3), 2013, p130 - 133 Journal Article, 2013

Non-Peer-Reviewed Publications

May P, Economic evidence for palliative care in Ireland, Systems not silos - Improving Palliative and End of Life Care in Secondary Care, Belfast, November, 2019, All-Ireland Institute for Hospice and Palliative Care Invited Talk, 2019

May P, Estimating future palliative care need in Ireland: a microsimulation approach, Expert Consultation on Future Palliative Care Need, Edinburgh, Scotland, September, 2019, Marie Curie/Univrsity of Edinburgh/Scottish Government Invited Talk, 2019

May P, Big data to advance economics of palliative and end-of-life care: some ongoing considerations, EAPC Big Data Taskforce Workshop, Amsterdam, November, 2019 Invited Talk, 2019

May P, Economics of palliative care: some key concepts, National Palliative Care Research Center Fellowship Program, New York, NY (Webinar), March, 2018 Invited Talk, 2018

May P, High costs in end-of-life care: Revisiting economic interpretations, International Health Economics Association webinar, November 30th, 2018, 2018 Invited Talk, 2018

May P, McGarrigle C, Normand C, The end of life experience of older adults in Ireland, Dublin, TILDA, Trinity College Dublin, December, 2017 Report, 2017 URL

May P, Economics of palliative care: understanding and interpreting evidence on costs and resource use, Hospice UK Annual Conference, Liverpool, England, November, 2017 Invited Talk, 2017

May P, Economics of palliative care: expanding our scope of enquiry, EAPC Congress, Madrid, Spain, May, 2017 Invited Talk, 2017

May P, Analysis of healthcare utilization data: some practical considerations for investigators in palliative care, National Palliative Care Research Center Fellowship Program, New York, NY (Webinar), February, 2016 Invited Talk, 2016

May P, Some basic principles of economic evaluation, Annual Kathleen Foley Retreat, Quebec, Canada, October, 2016 Invited Talk, 2016

Research Expertise

Description

Economics of health care for people with serious medical illness and complex needs. Key skills: modelling cost data, estimating treatment effects, analysing observational data, research design, causal inference, propensity scoring.

Projects

  • Title
    • Palliative and end-of-life care data in Ireland: establishing the state of the nation, mapping future direction
  • Summary
    • More people are living longer, increasing the need for expert care of complex medical illness. The end-of-life phase imposes severe physical and psychological burdens on people with terminal illness and their families. Contemporary health systems are not geared to providing good end-of-life care. Palliative care aims to maximise quality of remaining life. Current availability of palliative care in Ireland depends heavily on which area of the country you live in. Improving palliative and end-of-life care requires good data on current practices. However we currently know little about the end-of-life phase in Ireland: where people die, what health care they use, how family and friends provide unpaid care, and how palliative care shapes these experiences. This project aims to improve knowledge and understanding of these questions. We will access data from multiple government bodies on how people die. We will also use The Irish Longitudinal study on Ageing (TILDA), which since 2009 interviews a nationally representative cohort of people aged over 50 on their life experience, health and health care use. We will combine these data to describe national trends in death and dying; to measure differences in palliative care service by region; and to evaluate how local palliative care provision is associated with important indicators of end-of-life experience, e.g. pain, anxiety, death in preferred place. We will also compare the data currently collected by Department of Health and Health Service Executive against practices in other countries, to identify opportunities for improvement. Our results will improve provision and planning in palliative and end-of-life care by providing for the first time a national picture of how people die in Ireland, by quantifying how palliative care impacts these experiences, and by identifying ways in which services can be better evaluated and provided in future.
  • Funding Agency
    • Health Research Board
  • Date From
    • Feb 2020
  • Date To
    • Jan 2022
  • Title
    • Improving outcomes for patients with chronic illness & acute respiratory failure
  • Summary
    • Project Number: 1K23HL144830-01A1 Project Leader: KHANDELWAL, NITA Awardee Organization: UNIVERSITY OF WASHINGTON
  • Funding Agency
    • National Heart, Lung, and Blood Institute (United States)
  • Date From
    • Aug 2019
  • Date To
    • Aug 2023
  • Title
    • Family Spending after Hospice Enrollment: A Population-Based Study
  • Summary
    • Project Number: 1R01NR018462-01 Project Leader: ALDRIDGE, MELISSA DIANE Awardee Organization: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
  • Funding Agency
    • National Institute of Nursing Research (United States)
  • Date From
    • Aug 2019
  • Date To
    • Aug 2022
  • Title
    • Economics of palliative care: from international evidence to Irish policy
  • Summary
    • The aim of this project is to build a demographic/economic microsimulation model to predict the future older population in Ireland using TILDA data, and to evaluate policy options ex ante. In collaboration with University of Southern California and the Irish Department of Health.
  • Funding Agency
    • Health Research Board
  • Date From
    • Jan 2019
  • Date To
    • Dec 2021
  • Title
    • Psychoeducational Interventions for People with Cancer and their Caregivers (DIAdIC)
  • Summary
    • This is a six-country trial led by Vrije Universiteit Brussel (PI: Professor Joachim Cohen). The PaCE team led by Professor Normand is responsible for the economic evaluation work package.
  • Funding Agency
    • European Commission
  • Date From
    • Jan 2019
  • Date To
    • Dec 2023
  • Title
    • Population-based study of palliative care access, impact, and disparities
  • Summary
    • The primary goal of this study is to use population-level data to understand factors related to specialist palliative care use, and to explore three ways in which palliative care is related to outcomes including quality, disparities, and costs. A secondary goal is to demonstrate the feasibility and importance of acquiring data from disparate sources for population-based research on palliative care and outcomes for people with cancer. Led by Virginia Commonwealth University, Dr May is a co-investigator on the study.
  • Funding Agency
    • American Cancer Society
  • Date From
    • Jan 2019
  • Date To
    • Dec 2020
  • Title
    • Out-of-hours palliative care service provision: an evidence review
  • Summary
    • This project reviews systematically both the peer-reviewed academic literature and international policy and practice documentation to assemble best-available evidence on out-of-hours palliative care for adults. This project contributes to the ongoing review of national palliative care policy in Ireland.
  • Funding Agency
    • Department of Health
  • Date From
    • Aug 2018
  • Date To
    • Apr 2019
  • Title
    • Integrating Palliative Medicine in the Emergency Department (PalMED)
  • Summary
    • Quality improvement project to improve palliative medicine access in the emergency department of a large acute hospital.
  • Funding Agency
    • Health Service Executive
  • Date From
    • Jun 2018
  • Date To
    • May 2020
  • Title
    • Understanding inequalities in palliative care and Providing for future need (UP)
  • Summary
    • The aim of this mixed-methods research is to generate evidence on: - current and future palliative care needs in Ireland; - the magnitude and drivers of financial hardship among the seriously-ill and their households; - what is required to effect change and deliver on equitable provision.
  • Funding Agency
    • Health Service Executive
  • Date From
    • Mar 2018
  • Date To
    • Sep 2019
  • Title
    • Do we die as we live? Age, socioeconomics, health care & pathways to death in Ireland
  • Summary
    • This project uses data from the Irish Longitudinal Study on Ageing (TILDA) linked to death certificate records administered by the Central Statistics Office (CSO) to examine three key issues: 1) How does mortality vary across socioeconomic groups in the over 50s in Ireland? 2) To what extent does better access to the healthcare system reduce mortality from amenable causes, i.e., causes of death that could be prevented with timely and effective healthcare? 3) What are the determinants of healthcare utilisation and costs at the end of life in Ireland?
  • Funding Agency
    • Health Research Board
  • Date From
    • Jan 2018
  • Date To
    • Dec 2021
  • Title
    • Decongregation for people with an intellectual disability: an evidence review
  • Summary
    • This project reviews systematically the peer-reviewed academic literature on quality of life and cost-effects of deinstitutionalisation for adults with intellectual disabilities.
  • Funding Agency
    • Department of Health
  • Date From
    • Jul 2017
  • Date To
    • Apr 2018
  • Title
    • Economics of palliative care
  • Summary
    • PhD fellowship between Trinity College Dublin and Mount Sinai School of Medicine, NY.
  • Funding Agency
    • National Cancer Institute (United States)/Health Research Board
  • Date From
    • Jul 2011
  • Date To
    • Jun2015
  • Title
    • Can we improve outcomes, value and equity in care of serious illness? A study to advance economics of palliative care
  • Summary
    • I evaluate palliative care effects across the trajectory of disease, using three nationally representative datasets in Ireland and a natural experiment in palliative care provision. I hypothesise that palliative care improves quality and value of care for people with serious illness, while mitigating socioeconomic inequities associated with ageing. I have four aims. First, I estimate the cost-effectiveness of palliative care by diagnosis and comorbidity count among adults aged 50+ with serious medical illness. Second, I quantify potential equity gains given that mortality and multimorbidity burdens fall disproportionately on lower socioeconomic groups. Third, I seek multi-dimensional measures of need and deteriorating health to identify better those for whom palliative care is most beneficial. Fourth, I apply and compare these multi-dimensional measures to see how to maximise outcomes for available budgets.
  • Funding Agency
    • Wellcome Trust

Keywords

End-of-life care; HEALTH ECONOMICS; multimorbidity; PALLIATIVE CARE

Recognition

Memberships

International Health Economics Association (iHEA)

Health Economics Association of Ireland (HEAI)

Academy Health

All-Ireland Institute of Hospice and Palliative Care Research Network (PCRN)