End-of-life healthcare utilization and costs according to cause of death: a retrospective study
Notice bibliographique
Résumé
CONTEXT: Aging individuals are more likely to experience multiple health issues, resulting in increased and complex healthcare needs, particularly at the end-of-life (EoL). While several studies have shown that healthcare costs rose substantially during the final year and months of life, there is limited research on the EoL utilization and cost in Quebec, specifically using population-based data that span multiple healthcare settings and different causes of death. OBJECTIVE: To examine healthcare and social care utilization and cost during the last year of life of people who died in Quebec at the age of 66 and over, according to their cause of death. METHODS: We conducted a retrospective quantitative longitudinal study to analyze individuals' healthcare utilization and cost during their last year of life between 2014 and 2018. Individuals were retrieved from the death registry and classified according to their cause of death as: cancer, organ failure, frailty (physical or cognitive) and other or unknown. Healthcare and social care utilization included: medical visits, emergency department visits, hospitalizations, homecare and long-term care (LTC). Costs were attributed to services either directly from administrative databases or estimated from public financial reports. We used generalized linear models (GLMs) to assess variations in service utilization and costs: Poisson or negative binomial models were employed for count outcomes based on data dispersion, and Gamma log link for costs. RESULTS: The cohort included 21,255 individuals (52.6% women) with ~ 40% of deaths occurring among individuals aged 80-89 years. Nearly 50% of the cohort died from an organ failure, 30% of cancer and 15% of frailty. Cancer and organ failure were associated with high acute care use and costs, while frailty led to greater use of LTC and social care. Overall, the EoL the individual average cost was 34,467$ ($25,000-$53,000), depending on cause of death and type of services used. Notably, social services cost exceeds healthcare cost, especially for people who died from frailty, highlighting the financial burden of LTC accommodation. CONCLUSION: This study highlights distinct EoL healthcare and social services utilization and related costs among older adults, depending on the cause of death, age, and sex. These findings underscore the need for tailored care strategies that reflect different EoL trajectories.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».