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

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. Re... Mehr ...

Verfasser: Chantal F. R. Pereira
Anne-Floor Q. Dijxhoorn
Berdine Koekoek
Monique van den Broek
Karin van der Steen
Marijanne Engel
Marjon van Rijn
Judith M. Meijers
Jeroen Hasselaar
Agnes van der Heide
Bregje D. Onwuteaka-Philipsen
Marieke H. J. van den Beuken-van Everdingen
Yvette M. van der Linden
Manon S. Boddaert
Patrick P. T. Jeurissen
Matthias A. W. Merkx
Natasja J. H. Raijmakers
Dokumenttyp: Artikel
Erscheinungsdatum: 2024
Reihe/Periodikum: International Journal of Integrated Care, Vol 24, Pp 6-6 (2024)
Verlag/Hrsg.: Ubiquity Press
Schlagwörter: palliative care / integrated palliative care / potentially inappropriate end of life care / healthcare costs / Medicine (General) / R5-920
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29173068
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.5334/ijic.7504

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. Academic Disciplines: Medicine; Nursing; Health economics Research Sample: Deceased adults