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: Pereira, Chantal F. R.
Dijxhoorn, Anne-Floor Q.
Koekoek, Berdine
van den Broek, Monique
van der Steen, Karin
Engel, Marijanne
van Rijn, Marjon
Meijers, Judith M.
Hasselaar, Jeroen
van der Heide, Agnes
Onwuteaka-Philipsen, Bregje D.
van den Beuken-van Everdingen, Marieke H. J.
van der Linden, Yvette M.
Boddaert, Manon S.
Jeurissen, Patrick P. T.
Merkx, Matthias A. W.
Raijmakers, Natasja J. H.
Dokumenttyp: Artikel
Erscheinungsdatum: 2024
Verlag/Hrsg.: Ubiquity Press
Schlagwörter: palliative care / integrated palliative care / potentially inappropriate end of life care / healthcare costs
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29177811
Datenquelle: BASE; Originalkatalog
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Link(s) : https://account.ijic.org/index.php/up-j-ijic/article/view/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