Wang, Jiunn;
Shand, Jenny;
Gomes, Manuel;
(2023)
End-of-life care costs and place of death across health and social care sectors.
BMJ Supportive & Palliative Care
10.1136/spcare-2023-004356.
(In press).
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Abstract
Objectives: This study explores the relationship between end-of-life care costs and place of death across different health and social care sectors. // Methods: We used a linked local government and health data of East London residents (n=4661) aged 50 or over, deceased between 2016 and 2020. Individuals who died in hospital were matched to those who died elsewhere according to a wide range of demographic, socioeconomic and health factors. We reported mean healthcare costs and 95% CIs by care sectors over the 12-month period before death. Subgroup analyses were conducted to investigate if the role of place of death differs according to long-term conditions and age. // Results: We found that mean difference in total cost between hospital and non-hospital decedents was £4565 (95% CI £3132 to £6046). Hospital decedents were associated with higher hospital cost (£5196, £4499 to £5905), higher mental healthcare cost (£283, £78 to £892) and lower social care cost (−£838, −£1,209 to −£472), compared with individuals who died elsewhere. Subgroup analysis shows that the association between place of death and healthcare costs differs by age and long-term conditions, including cancer, mental health and cardiovascular diseases. // Conclusion: This study suggests that trajectories of end-of-life healthcare costs vary by place of death in a differential way across health and social care sectors. High hospital burden for cancer patients may be alleviated by strengthening healthcare provision in less cost-intensive settings, such as community and social care.
| Type: | Article |
|---|---|
| Title: | End-of-life care costs and place of death across health and social care sectors |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/spcare-2023-004356 |
| Publisher version: | http://dx.doi.org/10.1136/spcare-2023-004356 |
| Language: | English |
| Additional information: | Copyright © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0). https://creativecommons.org/, https://creativecommons.org/licenses/by-nc/4.0/ |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10176391 |
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