Potentially Inappropriate End of Life Care and Healthcare Costs in the Last 30 Days of Life in Regions Providing Integrated Palliative Care in the Netherlands: A Registration-based Study.
Publication year
2024Author(s)
Source
International Journal of Integrated Care (IJIC), 24, 3, (2024), pp. 6, article 6ISSN
Publication type
Article / Letter to editor
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Organization
Primary and Community Care
IQ health
Oral and Maxillofacial Surgery
Journal title
International Journal of Integrated Care (IJIC)
Volume
vol. 24
Issue
iss. 3
Page start
p. 6
Subject
IQ health - Radboud University Medical Center; Oral and Maxillofacial Surgery - Radboud University Medical Center; Primary and Community Care - Radboud University Medical CenterAbstract
INTRODUCTION: This study aimed to assess the effect of integrated palliative care (IPC) on potentially inappropriate end- of-life care and healthcare-costs in the last 30 days of life in the Netherlands. METHODS: Nationwide health-insurance claims data were used to assess potentially inappropriate end-of-life care (≥2 emergency room visits; ≥2 hospital admissions; >14 days hospitalization; chemotherapy; ICU admission; hospital death) and healthcare-costs in all deceased adults in IPC regions pre- and post- implementation and in those receiving IPC compared to a 1:2 matched control group. RESULTS: In regions providing IPC deceased adults (n = 37,468) received significantly less potentially inappropriate end-of-life care post-implementation compared to pre-implementation (26.5% vs 27.9%; p < 0.05). Deceased adults who received IPC (n = 210) also received significantly less potentially inappropriate end-of-life care compared to a matched control group (14.8% vs 28.3%; p < 0.05). Mean hospital costs significantly decreased for deceased adults who received IPC (€2,817), while mean costs increased for general practitioner services (€311) and home care (€1,632). DISCUSSION: These results highlight the importance of implementation of integrated palliative care and suitable payment. Further research in a larger sample is needed. CONCLUSION: This study shows less potentially inappropriate end-of-life care and a shift in healthcare costs from hospital to general practitioner and home care with IPC.
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- Academic publications [245186]
- Electronic publications [132505]
- Faculty of Medical Sciences [93207]
- Open Access publications [106079]
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