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International comparison of spending and utilization at the end of life for hip fracture patients

OBJECTIVE: To identify and explore differences in spending and utilization of key health services at the end of life among hip fracture patients across seven developed countries. DATA SOURCES: Individual‐level claims data from the inpatient and outpatient health care sectors compiled by the Internat...

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Autores principales: Blankart, Carl Rudolf, van Gool, Kees, Papanicolas, Irene, Bernal‐Delgado, Enrique, Bowden, Nicholas, Estupiñán‐Romero, Francisco, Gauld, Robin, Knight, Hannah, Abiona, Olukorede, Riley, Kristen, Schoenfeld, Andrew J., Shatrov, Kosta, Wodchis, Walter P., Figueroa, Jose F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579204/
https://www.ncbi.nlm.nih.gov/pubmed/34490633
http://dx.doi.org/10.1111/1475-6773.13734
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author Blankart, Carl Rudolf
van Gool, Kees
Papanicolas, Irene
Bernal‐Delgado, Enrique
Bowden, Nicholas
Estupiñán‐Romero, Francisco
Gauld, Robin
Knight, Hannah
Abiona, Olukorede
Riley, Kristen
Schoenfeld, Andrew J.
Shatrov, Kosta
Wodchis, Walter P.
Figueroa, Jose F.
author_facet Blankart, Carl Rudolf
van Gool, Kees
Papanicolas, Irene
Bernal‐Delgado, Enrique
Bowden, Nicholas
Estupiñán‐Romero, Francisco
Gauld, Robin
Knight, Hannah
Abiona, Olukorede
Riley, Kristen
Schoenfeld, Andrew J.
Shatrov, Kosta
Wodchis, Walter P.
Figueroa, Jose F.
author_sort Blankart, Carl Rudolf
collection PubMed
description OBJECTIVE: To identify and explore differences in spending and utilization of key health services at the end of life among hip fracture patients across seven developed countries. DATA SOURCES: Individual‐level claims data from the inpatient and outpatient health care sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC). STUDY DESIGN: We retrospectively analyzed utilization and spending from acute hospital care, emergency department, outpatient primary care and specialty physician visits, and outpatient drugs. Patterns of spending and utilization were compared in the last 30, 90, and 180 days across Australia, Canada, England, Germany, New Zealand, Spain, and the United States. We employed linear regression models to measure age‐ and sex‐specific effects within and across countries. In addition, we analyzed hospital‐centricity, that is, the days spent in hospital and site of death. DATA COLLECTION/EXTRACTION METHODS: We identified patients who sustained a hip fracture in 2016 and died within 12 months from date of admission. PRINCIPAL FINDINGS: Resource use, costs, and the proportion of deaths in hospital showed large variability being high in England and Spain, while low in New Zealand. Days in hospital significantly decreased with increasing age in Canada, Germany, Spain, and the United States. Hospital spending near date of death was significantly lower for women in Canada, Germany, and the United States. The age gradient and the sex effect were less pronounced in utilization and spending of emergency care, outpatient care, and drugs. CONCLUSIONS: Across seven countries, we find important variations in end‐of‐life care for patients who sustained a hip fracture, with some differences explained by sex and age. Our work sheds important insights that may help ongoing health policy discussions on equity, efficiency, and reimbursement in health care systems.
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spelling pubmed-85792042021-11-15 International comparison of spending and utilization at the end of life for hip fracture patients Blankart, Carl Rudolf van Gool, Kees Papanicolas, Irene Bernal‐Delgado, Enrique Bowden, Nicholas Estupiñán‐Romero, Francisco Gauld, Robin Knight, Hannah Abiona, Olukorede Riley, Kristen Schoenfeld, Andrew J. Shatrov, Kosta Wodchis, Walter P. Figueroa, Jose F. Health Serv Res Research Articles OBJECTIVE: To identify and explore differences in spending and utilization of key health services at the end of life among hip fracture patients across seven developed countries. DATA SOURCES: Individual‐level claims data from the inpatient and outpatient health care sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC). STUDY DESIGN: We retrospectively analyzed utilization and spending from acute hospital care, emergency department, outpatient primary care and specialty physician visits, and outpatient drugs. Patterns of spending and utilization were compared in the last 30, 90, and 180 days across Australia, Canada, England, Germany, New Zealand, Spain, and the United States. We employed linear regression models to measure age‐ and sex‐specific effects within and across countries. In addition, we analyzed hospital‐centricity, that is, the days spent in hospital and site of death. DATA COLLECTION/EXTRACTION METHODS: We identified patients who sustained a hip fracture in 2016 and died within 12 months from date of admission. PRINCIPAL FINDINGS: Resource use, costs, and the proportion of deaths in hospital showed large variability being high in England and Spain, while low in New Zealand. Days in hospital significantly decreased with increasing age in Canada, Germany, Spain, and the United States. Hospital spending near date of death was significantly lower for women in Canada, Germany, and the United States. The age gradient and the sex effect were less pronounced in utilization and spending of emergency care, outpatient care, and drugs. CONCLUSIONS: Across seven countries, we find important variations in end‐of‐life care for patients who sustained a hip fracture, with some differences explained by sex and age. Our work sheds important insights that may help ongoing health policy discussions on equity, efficiency, and reimbursement in health care systems. Blackwell Publishing Ltd 2021-09-07 2021-12 /pmc/articles/PMC8579204/ /pubmed/34490633 http://dx.doi.org/10.1111/1475-6773.13734 Text en © 2021 The Authors. Health Services Research published by Wiley Periodicals LLC on behalf of Health Research and Educational Trust. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Blankart, Carl Rudolf
van Gool, Kees
Papanicolas, Irene
Bernal‐Delgado, Enrique
Bowden, Nicholas
Estupiñán‐Romero, Francisco
Gauld, Robin
Knight, Hannah
Abiona, Olukorede
Riley, Kristen
Schoenfeld, Andrew J.
Shatrov, Kosta
Wodchis, Walter P.
Figueroa, Jose F.
International comparison of spending and utilization at the end of life for hip fracture patients
title International comparison of spending and utilization at the end of life for hip fracture patients
title_full International comparison of spending and utilization at the end of life for hip fracture patients
title_fullStr International comparison of spending and utilization at the end of life for hip fracture patients
title_full_unstemmed International comparison of spending and utilization at the end of life for hip fracture patients
title_short International comparison of spending and utilization at the end of life for hip fracture patients
title_sort international comparison of spending and utilization at the end of life for hip fracture patients
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579204/
https://www.ncbi.nlm.nih.gov/pubmed/34490633
http://dx.doi.org/10.1111/1475-6773.13734
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