Canada’s End-Of-Life Care is More Hospital Centric

The cost of end-of-life care among developed countries varies based on the policies implemented. This study compared site of death, health care utilization, and hospital expenditures in 7 developed countries (Belgium, Canada, England, Germany, the Netherlands, Norway, and the United States). To address the knowledge gap in cross-national end-of-life research, the authors formed the International Consortium for End-of-Life Research (ICELR), and conducted a systematic evaluation.

ICELR performed a retrospective observational study of people who were dying with cancer in 2010 was performed, using administrative claims or registry data sets. Participants were decedents over the age of 65 who died with cancer, and secondary analysis included decedents of any age, decedents over the age of 65 with lung cancer, and decedents over the age of 65 in the United States in Germany in 2012.

Researchers found that the number of deaths in acute care ranged from 52.1%-22.2%, with Canada having the highest percentage at 52.1%. In the last 180 days of life 87.1% of Canada’s patients were hospitalized with the range from Belgium, Canada, England, and Norway being between 82.6%-88.7%. As well, in the last 180 days of life Canada’s patients had the highest per capita hospital expenditures at $21 840 US. When researchers looked into the last 30 days of life Canada ranked highest in in per capita hospital expenditures being $10 273 US. In the last 30 days of life Canadian patients hospitalization in acute care increased to 60.2%

This study discovered that people in Belgium, Canada, Germany and Norway received more hospital-centric care in their last days of life. The higher hospital-centric care given has higher expenditures for the patients than if not hospitalized. This article received some excellent coverage and discussion by the CBC, which noted that some countries like the Netherlands have a much greater capacity to deliver palliative/hospice care than countries like Canada and the US, who spend much more on end-of-life care. This study further highlights that treatment in hospital is a major driver of cost for the care received.

For Further Information about this study visit: http://jama.jamanetwork.com/article.aspx?articleid=2482325

For the CBC new report:

http://www.cbc.ca/news/health/end-of-life-palliative-hospice-1.3410064