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Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective

BACKGROUND: There is growing interest in end-of-life care in cancer patients. We aim to characterise health service use and costs in decedents with cancer history and examine factors associated with resource use and costs at life's end. METHODS: We used routinely collected claims data to quanti...

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Autores principales: Langton, Julia M, Reeve, Rebecca, Srasuebkul, Preeyaporn, Haas, Marion, Viney, Rosalie, Currow, David, Pearson, Sallie-Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4891509/
https://www.ncbi.nlm.nih.gov/pubmed/27115468
http://dx.doi.org/10.1038/bjc.2016.75
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author Langton, Julia M
Reeve, Rebecca
Srasuebkul, Preeyaporn
Haas, Marion
Viney, Rosalie
Currow, David
Pearson, Sallie-Anne
author_facet Langton, Julia M
Reeve, Rebecca
Srasuebkul, Preeyaporn
Haas, Marion
Viney, Rosalie
Currow, David
Pearson, Sallie-Anne
author_sort Langton, Julia M
collection PubMed
description BACKGROUND: There is growing interest in end-of-life care in cancer patients. We aim to characterise health service use and costs in decedents with cancer history and examine factors associated with resource use and costs at life's end. METHODS: We used routinely collected claims data to quantify health service use and associated costs in two cohorts of elderly Australians diagnosed with cancer: one cohort died from cancer (n=4271) and the other from non-cancer causes (n=3072). We used negative binomial regression to examine the factors associated with these outcomes. RESULTS: Those who died from cancer had significantly higher rates of hospitalisations and medicine use but lower rates of emergency department use than those who died from non-cancer causes. Overall health care costs were significantly higher in those who died from cancer than those dying from other causes; and 40% of costs were expended in the last month of life. CONCLUSIONS: We analysed health services use and costs from a payer perspective, and highlight important differences in patterns of care by cause of death in patients with a cancer history. In particular, there are growing numbers of highly complex patients approaching the end of life and the heterogeneity of these populations may present challenges for effective health service delivery.
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spelling pubmed-48915092017-05-24 Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective Langton, Julia M Reeve, Rebecca Srasuebkul, Preeyaporn Haas, Marion Viney, Rosalie Currow, David Pearson, Sallie-Anne Br J Cancer Epidemiology BACKGROUND: There is growing interest in end-of-life care in cancer patients. We aim to characterise health service use and costs in decedents with cancer history and examine factors associated with resource use and costs at life's end. METHODS: We used routinely collected claims data to quantify health service use and associated costs in two cohorts of elderly Australians diagnosed with cancer: one cohort died from cancer (n=4271) and the other from non-cancer causes (n=3072). We used negative binomial regression to examine the factors associated with these outcomes. RESULTS: Those who died from cancer had significantly higher rates of hospitalisations and medicine use but lower rates of emergency department use than those who died from non-cancer causes. Overall health care costs were significantly higher in those who died from cancer than those dying from other causes; and 40% of costs were expended in the last month of life. CONCLUSIONS: We analysed health services use and costs from a payer perspective, and highlight important differences in patterns of care by cause of death in patients with a cancer history. In particular, there are growing numbers of highly complex patients approaching the end of life and the heterogeneity of these populations may present challenges for effective health service delivery. Nature Publishing Group 2016-05-24 2016-04-26 /pmc/articles/PMC4891509/ /pubmed/27115468 http://dx.doi.org/10.1038/bjc.2016.75 Text en Copyright © 2016 Cancer Research UK http://creativecommons.org/licenses/by-nc-sa/4.0/ From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/
spellingShingle Epidemiology
Langton, Julia M
Reeve, Rebecca
Srasuebkul, Preeyaporn
Haas, Marion
Viney, Rosalie
Currow, David
Pearson, Sallie-Anne
Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective
title Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective
title_full Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective
title_fullStr Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective
title_full_unstemmed Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective
title_short Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective
title_sort health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4891509/
https://www.ncbi.nlm.nih.gov/pubmed/27115468
http://dx.doi.org/10.1038/bjc.2016.75
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