Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective

Julia M. Langton, Rebecca Reeve, Preeyaporn Srasuebkul, Marion Haas, Rosalie Viney, David C. Currow, Sallie Anne Pearson, EOL-CC study authors, Bonny Parkinson, Yuanyuan Gu

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background:
There is growing interest in end-of-life care in cancer patients. We aim to characterise health service use and costs in decedents with cancer history and examine factors associated with resource use and costs at life’s end.

Methods:
We used routinely collected claims data to quantify health service use and associated costs in two cohorts of elderly Australians diagnosed with cancer: one cohort died from cancer (n=4271) and the other from non-cancer causes (n=3072). We used negative binomial regression to examine the factors associated with these outcomes.

Results:
Those who died from cancer had significantly higher rates of hospitalisations and medicine use but lower rates of emergency department use than those who died from non-cancer causes. Overall health care costs were significantly higher in those who died from cancer than those dying from other causes; and 40% of costs were expended in the last month of life.

Conclusions:
We analysed health services use and costs from a payer perspective, and highlight important differences in patterns of care by cause of death in patients with a cancer history. In particular, there are growing numbers of highly complex patients approaching the end of life and the heterogeneity of these populations may present challenges for effective health service delivery.
LanguageEnglish
Pages1293-1302
Number of pages10
JournalBritish Journal of Cancer
Volume114
DOIs
Publication statusPublished - 24 May 2016

Fingerprint

Health Care Costs
Health Services
Health
Neoplasms
Costs and Cost Analysis
Terminal Care
Population Characteristics
Hospital Emergency Service
Cause of Death
Hospitalization
Medicine

Keywords

  • end-of-life care
  • terminal care
  • neoplasm
  • veterans health
  • health care utilization
  • health care costs

Cite this

Langton, Julia M. ; Reeve, Rebecca ; Srasuebkul, Preeyaporn ; Haas, Marion ; Viney, Rosalie ; Currow, David C. ; Pearson, Sallie Anne ; EOL-CC study authors. / Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer : a comprehensive analysis from a health payer perspective. In: British Journal of Cancer. 2016 ; Vol. 114. pp. 1293-1302.
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abstract = "Background:There is growing interest in end-of-life care in cancer patients. We aim to characterise health service use and costs in decedents with cancer history and examine factors associated with resource use and costs at life’s end.Methods:We used routinely collected claims data to quantify health service use and associated costs in two cohorts of elderly Australians diagnosed with cancer: one cohort died from cancer (n=4271) and the other from non-cancer causes (n=3072). We used negative binomial regression to examine the factors associated with these outcomes.Results:Those who died from cancer had significantly higher rates of hospitalisations and medicine use but lower rates of emergency department use than those who died from non-cancer causes. Overall health care costs were significantly higher in those who died from cancer than those dying from other causes; and 40{\%} of costs were expended in the last month of life.Conclusions:We analysed health services use and costs from a payer perspective, and highlight important differences in patterns of care by cause of death in patients with a cancer history. In particular, there are growing numbers of highly complex patients approaching the end of life and the heterogeneity of these populations may present challenges for effective health service delivery.",
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Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer : a comprehensive analysis from a health payer perspective. / Langton, Julia M.; Reeve, Rebecca; Srasuebkul, Preeyaporn; Haas, Marion; Viney, Rosalie; Currow, David C.; Pearson, Sallie Anne; EOL-CC study authors.

In: British Journal of Cancer, Vol. 114, 24.05.2016, p. 1293-1302.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Haas, Marion

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AU - Gu, Yuanyuan

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N2 - Background:There is growing interest in end-of-life care in cancer patients. We aim to characterise health service use and costs in decedents with cancer history and examine factors associated with resource use and costs at life’s end.Methods:We used routinely collected claims data to quantify health service use and associated costs in two cohorts of elderly Australians diagnosed with cancer: one cohort died from cancer (n=4271) and the other from non-cancer causes (n=3072). We used negative binomial regression to examine the factors associated with these outcomes.Results:Those who died from cancer had significantly higher rates of hospitalisations and medicine use but lower rates of emergency department use than those who died from non-cancer causes. Overall health care costs were significantly higher in those who died from cancer than those dying from other causes; and 40% of costs were expended in the last month of life.Conclusions:We analysed health services use and costs from a payer perspective, and highlight important differences in patterns of care by cause of death in patients with a cancer history. In particular, there are growing numbers of highly complex patients approaching the end of life and the heterogeneity of these populations may present challenges for effective health service delivery.

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