Titre
Healthcare trajectories and costs in the last year of life: a retrospective primary care and hospital analysis
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Luta, Xhyljeta
Auteure/Auteur
Diernberger, Katharina
Auteure/Auteur
Bowden, Joanna
Auteure/Auteur
Droney, Joanne
Auteure/Auteur
Howdon, Daniel
Auteure/Auteur
Schmidlin, Kurt
Auteure/Auteur
Rodwin, Victor
Auteure/Auteur
Hall, Peter
Auteure/Auteur
Marti, Joachim
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
2045-435X
Statut éditorial
Publié
Date de publication
2020-12-02
Volume
14
Numéro
1
Peer-reviewed
Oui
Langue
anglais
Résumé
To analyse healthcare utilisation and costs in the last year of life in England, and to study variation by cause of death, region of patient residence and socioeconomic status.
This is a retrospective cohort study. Individuals aged 60 years and over (N=108 510) who died in England between 2010 and 2017 were included in the study.
Healthcare utilisation and costs in the last year of life increased with proximity to death, particularly in the last month of life. The mean total costs were higher among males (£8089) compared with females (£6898) and declined with age at death (£9164 at age 60-69 to £5228 at age 90+) with inpatient care accounting for over 60% of total costs. Costs decline with age at death (0.92, 95% CI 0.88 to 0.95, p<0.0001 for age group 90+ compared with to the reference category age group 60-69) and were lower among females (0.91, 95% CI 0.90 to 0.92, p<0.0001 compared with males). Costs were higher (1.09, 95% CI 1.01 to 1.14, p<0.0001) in London compared with other regions.
Healthcare utilisation and costs in the last year of life increase with proximity to death, particularly in the last month of life. Finer geographical data and information on healthcare supply would allow further investigating whether people receiving more planned care by primary care and or specialist palliative care towards the end of life require less acute care.
This is a retrospective cohort study. Individuals aged 60 years and over (N=108 510) who died in England between 2010 and 2017 were included in the study.
Healthcare utilisation and costs in the last year of life increased with proximity to death, particularly in the last month of life. The mean total costs were higher among males (£8089) compared with females (£6898) and declined with age at death (£9164 at age 60-69 to £5228 at age 90+) with inpatient care accounting for over 60% of total costs. Costs decline with age at death (0.92, 95% CI 0.88 to 0.95, p<0.0001 for age group 90+ compared with to the reference category age group 60-69) and were lower among females (0.91, 95% CI 0.90 to 0.92, p<0.0001 compared with males). Costs were higher (1.09, 95% CI 1.01 to 1.14, p<0.0001) in London compared with other regions.
Healthcare utilisation and costs in the last year of life increase with proximity to death, particularly in the last month of life. Finer geographical data and information on healthcare supply would allow further investigating whether people receiving more planned care by primary care and or specialist palliative care towards the end of life require less acute care.
PID Serval
serval:BIB_32F3C56C5921
PMID
Open Access
Oui
Date de création
2020-12-21T14:25:59.483Z
Date de création dans IRIS
2025-05-20T13:24:21Z