TY - JOUR
T1 - 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
T2 - A Registration-based Study
AU - Pereira, Chantal F R
AU - Dijxhoorn, Anne-Floor Q
AU - Koekoek, Berdine
AU - van den Broek, Monique
AU - van der Steen, Karin
AU - Engel, Marijanne
AU - van Rijn, Marjon
AU - Meijers, Judith M
AU - Hasselaar, Jeroen
AU - van der Heide, Agnes
AU - Onwuteaka-Philipsen, Bregje D
AU - van den Beuken-van Everdingen, Marieke H J
AU - van der Linden, Yvette M
AU - Boddaert, Manon S
AU - Jeurissen, Patrick P T
AU - Merkx, Matthias A W
AU - Raijmakers, Natasja J H
PY - 2024/7/8
Y1 - 2024/7/8
N2 - 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.
AB - 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.
KW - Deceased adults
KW - Health economics
KW - Medicine
KW - Nursing
KW - healthcare costs
KW - integrated palliative care
KW - palliative care
KW - potentially inappropriate end of life care
U2 - 10.5334/ijic.7504
DO - 10.5334/ijic.7504
M3 - Article
SN - 1568-4156
VL - 24
JO - International Journal of Integrated Care
JF - International Journal of Integrated Care
IS - 3
M1 - 6
ER -