Janine Calver1, Max Bulsara, Duncan Boldy. 1. Centre for Research into Aged Care Services, Curtin University of Technology, Western Australia. janine.calver@health.wa.gov.au
Abstract
OBJECTIVES: To estimate the likelihood and costs of in-patient care in the last three years of life. METHODS: A population-based retrospective cohort study using linked hospital and death records to evaluate in-patient use by Western Australians who died in 2002. RESULTS: Age was unrelated to the likelihood of in-patient admission and inversely related to in-patient costs, after adjustment for sex, cause of death and proximity to death. In-patient costs increased in the final three quarters before death. In the last quarter before death, the predicted average quarterly in-patient cost increased 2.8 fold from quarter two and 3.8 fold from quarter three. CONCLUSIONS: Older decedents were not more likely to be hospitalised than younger decedents in the final three years of life. Moreover, once hospitalised, their in-patient costs were lower. In-patient costs were heavily concentrated in the three last quarters of life. IMPLICATIONS: Remaining lifetime is a significant predictor of in-patient costs. Failure to account for proximity to death will overemphasise the impact of population ageing on health care expenditure, because older people have a higher probability of dying.
OBJECTIVES: To estimate the likelihood and costs of in-patient care in the last three years of life. METHODS: A population-based retrospective cohort study using linked hospital and death records to evaluate in-patient use by Western Australians who died in 2002. RESULTS: Age was unrelated to the likelihood of in-patient admission and inversely related to in-patient costs, after adjustment for sex, cause of death and proximity to death. In-patient costs increased in the final three quarters before death. In the last quarter before death, the predicted average quarterly in-patient cost increased 2.8 fold from quarter two and 3.8 fold from quarter three. CONCLUSIONS: Older decedents were not more likely to be hospitalised than younger decedents in the final three years of life. Moreover, once hospitalised, their in-patient costs were lower. In-patient costs were heavily concentrated in the three last quarters of life. IMPLICATIONS: Remaining lifetime is a significant predictor of in-patient costs. Failure to account for proximity to death will overemphasise the impact of population ageing on health care expenditure, because older people have a higher probability of dying.
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