Abstract
Objectives
Design
Setting and Participants
Methods
Results
Conclusions and Implications
Keywords
- Diernberger K.
- Luta X.
- Bowden J.
- et al.
- Georghiou T.
- Bardsley M.
Methods
Study Design
Population
Outcome
Formal Costs
- −Hospital costs: in-hospital, intensive care, emergency room visits, ambulance services, and outpatients hospital contacts
- −Care home costs: care home stays with nursing (nursing home) or without nursing (residential care home)
- −Community costs: primary [general practitioner (GP) face-to-face and telephone contacts], community (community nurses, physiotherapists, occupational therapists), spiritual care, social care services, and formal carer
- −Palliative care costs: specialist palliative care services in hospital, hospice, or community based (including Macmillan and Marie Curie nurses)
Informal Care Costs
- −Time spent by family or friends caring for the participant including helping with household tasks, going to medical appointments, and providing personal care to the decedent
Explanatory Variables
Covariables
Analysis
Results
Characteristics of the Study Sample
Total Sample (N = 146) | Transition to Hospital | ||
---|---|---|---|
No (n = 61) | Yes (n = 85) | ||
Decedent's characteristics | |||
Age, y, mean ± SD | 88.09 ± 6.02 | 89.43 ± 4.75 | 87.13 ± 6.65 |
Ethnicity | |||
White | 137 (93.8) | 60 (98.4) | 77 (90.6) |
Non-White | 8 (5.5) | 0 (0.0) | 8 (9.4) |
Missing | 1 (0.7) | 1 (1.6) | 0 (0.0) |
Gender | |||
Male | 48 (32.9) | 16 (26.2) | 32 (37.6) |
Female | 98 (67.1) | 45 (73.8) | 53 (62.4) |
Financial status | |||
Living comfortably or doing alright | 110 (75.3) | 45 (73.8) | 65 (76.5) |
Just about getting by | 20 (13.7) | 8 (13.1) | 12 (14.1) |
Finding it quite or very difficult | 8 (5.5) | 4 (6.6) | 4 (4.7) |
Missing | 8 (5.5) | 4 (6.6) | 4 (4.7) |
Marital status | |||
Married or with partner | 45 (30.8) | 13 (21.3) | 32 (37.6) |
Widowed, divorced, or single | 93 (63.7) | 44 (72.1) | 49 (57.6) |
Missing | 8 (5.5) | 4 (6.6) | 4 (4.7) |
Usual place of care in last 3 mo | |||
Home | 58 (39.7) | 15 (24.6) | 43 (50.6) |
Hospital | 3 (2.1) | 0 (0.0) | 3 (3.5) |
Care home | 85 (58.2) | 46 (75.4) | 39 (45.9) |
Place of death | |||
Home | 23 (15.8) | 15 (24.6) | 8 (9.4) |
Hospital | 57 (39.0) | 0 (0.0) | 57 (67.1) |
Care home | 65 (44.5) | 46 (75.4) | 19 (22.4) |
Missing | 1 (0.7) | 0 (0.0) | 1 (1.2) |
Proximity to death discussed | |||
No | 102 (69.9) | 46 (75.4) | 56 (65.9) |
Yes | 44 (30.1) | 15 (24.6) | 29 (34.1) |
Having a key contact | |||
No | 48 (32.9) | 13 (21.3) | 35 (41.2) |
Yes | 78 (53.4) | 42 (68.9) | 36 (42.4) |
Missing | 20 (13.7) | 6 (9.8) | 14 (16.5) |
EQ5D index, mean ± SD | 0.68 ± 0.13 | 0.70 ± 0.06 | 0.66 ± 0.16 |
Pain or discomfort in last 3 mo (EQ5D) | |||
No or slight problems | 110 (75.3) | 49 (80.3) | 61 (71.8) |
Moderate problems | 23 (15.8) | 7 (11.5) | 16 (18.8) |
Severe problems | 1 (0.7) | 0 (0.0) | 1 (1.2) |
Missing | 12 (8.2) | 5 (8.2) | 7 (8.2) |
Anxiety or depression in last 3 mo (EQ5D) | |||
No or slight problems | 96 (65.8) | 46 (75.4) | 50 (58.8) |
Moderate problems | 31 (21.2) | 12 (19.7) | 19 (22.4) |
Severe problems | 3 (2.1) | 0 (0.0) | 3 (3.5) |
Missing | 16 (11.0) | 3 (4.9) | 13 (15.3) |
Source | |||
IARE-I | 27 (18.5) | 6 (9.8) | 21 (24.7) |
IARE-II | 22 (15.1) | 0 (0.0) | 22 (25.9) |
OPTCare elderly | 97 (66.4) | 55 (90.2) | 42 (49.4) |
Respondent characteristics | |||
Age, y, mean ± SD | 64.86 ± 9.84 | 63.60 ± 8.41 | 65.76 ± 10.70 |
Relationship | |||
Husband or wife | 28 (19.2) | 5 (8.2) | 23 (27.1) |
Son or daughter | 94 (64.4) | 43 (70.5) | 51 (60.0) |
Other | 24 (16.4) | 13 (21.3) | 11 (12.9) |
Sex | |||
Male | 48 (32.9) | 19 (31.2) | 29 (34.1) |
Female | 98 (67.1) | 42 (68.8) | 56 (65.9) |
Education | |||
No education | 3 (2.1) | 1 (1.6) | 2 (2.4) |
Secondary school | 86 (58.9) | 32 (52.5) | 54 (63.5) |
University | 44 (30.1) | 25 (41.0) | 19 (22.4) |
Missing | 13 (8.9) | 3 (4.9) | 10 (11.8) |
Ethnicity | |||
White | 136 (93.2) | 58 (95.1) | 78 (91.8) |
Non-White | 10 (6.8) | 3 (4.9) | 7 (8.2) |
Transition to Hospital and Usual Place of Care
Service Use in the Last 3 Months of Life
Total Sample (N = 146) | Transition to Hospital | ||||||||
---|---|---|---|---|---|---|---|---|---|
No (n = 61) | Yes (n = 85) | ||||||||
No. of People With ≥1 Contact (%) | Mean Number of Contacts (SD) | Mean Cost in £ (SD) | No. of People With ≥1 Contact (%) | Mean Number of Contacts (SD) | Mean Cost, £ (SD) | No. of People With ≥1 Contact (%) | Mean Number of Contacts (SD) | Mean Cost, £ (SD) | |
Hospital care | |||||||||
In-hospital, d | 73 (50.0) | 6.9 (14.0) | 6285.3 (10,791.2) | 0 (0.0) | 0.0 (0.0) | 0 (0) | 73 (85.9) | 11.9 (16.7) | 10,795.9 (12,318.2) |
ICU, d | 17 (11.6) | 1.5 (6.7) | 2656.5 (10,620.2) | 0 (0.0) | 0.0 (0.0) | 0 (0) | 17 (20.0) | 2.7 (8.6) | 4562.9 (13,634.3) |
ED visits | 71 (48.6) | 0.8 (1.2) | 95.8 (134.3) | 4 (6.6) | 0.1 (0.3) | 9.3 (37.4) | 67 (78.8) | 1.3 (1.3) | 157.9 (144.3) |
Ambulance calls | 78 (53.4) | 0.8 (1.2) | 120.6 (140.9) | 8 (13.1) | 0.2 (0.5) | 23.3 (67.6) | 70 (82.4) | 1.3 (1.3) | 190.5 (138.4) |
Outpatient hospital appointment | 24 (16.4) | 0.3 (1.1) | 55.8 (171.1) | 3 (4.9) | 0.0 (0.2) | 9.8 (46.2) | 21 (24.7) | 0.5 (1.4) | 88.8 (215.3) |
Psychiatrist appointment | 14 (9.6) | 0.1 (0.6) | 29.9 (100.8) | 5 (8.2) | 0.1 (0.6) | 24.9 (88.9) | 9 (10.6) | 0.1 (0.6) | 33.5 (108.9) |
Total hospital costs | 9243.8 (15087.0) | 67.2 (173.9) | 15,829.4 (16,966.1) | ||||||
Care home | |||||||||
Nursing home, d | 64 (43.8) | 29.7 (40.8) | 4406.4 (5465.9) | 39 (63.9) | 52.5 (44.7) | 7191.7 (5709.2) | 25 (29.4) | 13.3 (28.2) | 2407.5 (4314.2) |
Residential care home, d | 34 (23.3) | 10.2 (27.0) | 2508.3 (4915.6) | 9 (14.8) | 8.9 (26.9) | 1713.5 (4401.9) | 25 (29.4) | 11.1 (27.2) | 3078.6 (5204) |
Any care home, d | 90 (61.6%) | 39.9 (42.8) | 6914.7 (5720.2) | 44 (72.1) | 61.5 (42.2) | 8905.3 (5224.1) | 46 (54.1) | 24.4 (36.1) | 5486.1 (5660.9) |
Total care home costs | 6914.7 (5720.2) | 8905.3 (5224.1) | 5486.1 (5660.9) | ||||||
Community care | |||||||||
Contacts with community nurses | 95 (65.1) | 2.7 (12.7) | 163 (427.1) | 46 (75.4) | 2.2 (12.8) | 164.8 (437.8) | 49 (57.6) | 3.1 (12.7) | 161.7 (421.8) |
GP face-to-face contacts | 128 (87.7) | 0.6 (1.7) | 89.8 (50.6) | 59 (96.7) | 0.2 (0.9) | 97.6 (24.9) | 69 (81.2) | 0.8 (2.1) | 84.2 (62.5) |
GP telephone contacts | 51 (34.9) | 0.2 (0.9) | 6.4 (9.8) | 24 (39.3) | 0.1 (0.9) | 7.3 (10.6) | 27 (31.8) | 0.2 (0.9) | 5.7 (9.3) |
Contacts with physiotherapist | 17 (11.6) | 0.3 (1.0) | 9.7 (32.6) | 6 (9.8) | 0.2 (1.0) | 9.3 (32.3) | 11 (12.9) | 0.3 (1.1) | 10.1 (33.0) |
Contacts with occupational therapist | 26 (17.8) | 0.3 (1.2) | 12.4 (37.8) | 8 (13.1) | 0.3 (1.6) | 12.4 (47.8) | 18 (21.2) | 0.3 (0.9) | 12.5 (28.9) |
Contacts with social care worker | 32 (21.9) | 0.3 (1.0) | 15.4 (38.3) | 10 (16.4) | 0.1 (0.5) | 8.9 (23) | 22 (25.9) | 0.4 (1.2) | 20.1 (45.8) |
Day care | 3 (2.1) | 0.0 (0.2) | 2.6 (18.2) | 0 (0.0) | 0.0 (0.0) | 0 (0) | 3 (3.5) | 0.0 (0.2) | 4.5 (23.8) |
Contacts with psychologists | 3 (2.1) | 0.0 (0.0) | 0 (0) | 1 (1.6) | 0.0 (0.0) | 0 (0) | 2 (2.4) | 0.0 (0.0) | 0 (0) |
Spiritual care | 28 (19.2) | 0.5 (1.7) | 9.1 (25.3) | 19 (31.1) | 0.9 (2.5) | 16.6 (35.4) | 9 (10.6) | 0.1 (0.6) | 3.8 (11.6) |
Other professionals | 24 (16.4) | 0.5 (3.3) | 104.4 (493.9) | 9 (14.8) | 0.2 (1.5) | 68.6 (246.5) | 15 (17.6) | 0.8 (4.1) | 130.2 (613.3) |
Paid carer, hpw | 45 (30.8) | 8.0 (48.0) | 1891.2 (5539.6) | 15 (24.6) | 14.3 (73.7) | 2294.3 (7995.2) | 30 (35.3) | 3.5 (7.0) | 1602 (2666.5) |
Total community care costs | 2304.2 (5679.9) | 2679.7 (8040.7) | 2034.7 (3054.9) | ||||||
Palliative care | |||||||||
In-hospice, d | 3 (2.1) | 0.1 (0.7) | 62.9 (440) | 1 (1.6) | 0.1 (0.6) | 41.8 (326.7) | 2 (2.4) | 0.1 (0.8) | 78 (507.3) |
Contacts with palliative care nurses | 10 (6.8) | 1.1 (9.4) | 92.6 (486) | 7 (11.5) | 2.2 (13.6) | 114.9 (585.3) | 3 (3.5) | 0.0 (0.0) | 76.6 (402.9) |
Contacts with palliative care physician | 22 (15.1) | 1.5 (9.6) | 360.7 (1855.9) | 10 (16.4) | 1.9 (11.9) | 481.9 (2286.8) | 12 (14.1) | 1.2 (7.7) | 273.7 (1480.5) |
Total palliative care costs | 516.2 (2117.4) | 638.6 (2372.0) | 428.3 (1924) | ||||||
Informal care | |||||||||
Time spent in personal care, hpw | 63 (43.2) | 9.4 (17.6) | 3505.1 (6340.9) | 19 (31.1) | 7.2 (16.2) | 2579 (5845.3) | 44 (51.8) | 11.1 (18.5) | 4169.6 (6627.9) |
Time spent in medical procedures, hpw | 60 (41.1) | 6.6 (14.7) | 3120.5 (6852.8) | 17 (27.9) | 4.7 (12.9) | 2194.2 (6036.1) | 43 (50.6) | 7.9 (15.7) | 3785.3 (7346.3) |
Time spent in appointments, hpw | 54 (37.0) | 1.9 (6.6) | 307 (1003.9) | 12 (19.7) | 0.3 (0.9) | 80.7 (164.5) | 42 (49.4) | 3.1 (8.4) | 469.3 (1287.1) |
Time spent helping with household, hpw | 56 (38.4) | 9.3 (16.7) | 1575.3 (2728.9) | 14 (23.0) | 4.2 (11.4) | 694.3 (1864.8) | 42 (49.4) | 12.9 (18.8) | 2207.5 (3066.4) |
Time spent with decedent, hpw | 125 (85.6) | 22.1 (34.3) | 3738 (5577.9) | 49 (80.3) | 9.6 (17.7) | 1707.5 (2887.3) | 76 (89.4) | 31.1 (40.1) | 5195.2 (6527.6) |
Total informal care costs | 12,245.8 (18,415.1) | 7255.8 (15,226.2) | 15,826.9 (19,715.9) | ||||||
Total costs | 31,224.7 (23,536.6) | 19,546.6 (17,899.2) | 39,605.5 (23,607.4) |
Costs of Care

Total Costs | Formal Care Costs | Informal Care Costs | |||||||
---|---|---|---|---|---|---|---|---|---|
Adjusted Mean | 95% CI | P Value | Adjusted Mean | 95% CI | P Value | Adjusted Mean | 95% CI | P Value | |
Transition to hospital | |||||||||
No | 21,522.0 | (17,784.0-26,045.8) | 11,517.0 | (9500.0-13,962.2) | 6744.3 | (3865.9-11,765.8) | |||
Yes | 33,239.2 | (28,301.8-39,037.8) | .002 | 23,006.7 | (19,586.7-27,023.8) | <.001 | 7271.0 | (4568.0-11,573.5) | .85 |
Usual place of care | |||||||||
Home | 34,331.4 | (27,824.7-42,359.5) | 14,351.7 | (11,755.4-17,521.3) | 18,316.9 | (9952.5-33,710.9) | |||
Care home | 23,801.3 | (20,172.0-28,083.6) | .016 | 19,321.4 | (16,499.2-22,626.4) | .038 | 3667.4 | (2280.1-5898.8) | <.001 |

Discussion
- van der Plas A.G.
- Oosterveld-Vlug M.G.
- Pasman H.R.
- Onwuteaka-Philipsen B.D.
Strengths and Limitations
Conclusions and Implications
Acknowledgments
Supplementary Data
Supplementary Material 1
IARE-I | IARE-II | OPTCare Elderly | |
---|---|---|---|
Setting | London | London | Southern England |
Data collection period | 2012 | 2017-2018 | 2012 |
Recruitment | 2 hospitals | 3 hospitals | Death certificates, ONS |
Inclusion criteria | Decedent ≥65 y old Accessed (≥1 contact) palliative care team | Decedent ≥65 y old Rockwood Clinical Frailty Score (CFS) ≥5 | Decedent ≥75 y old |
Exclusion criteria | Unable to give informed consent | Receiving specialist palliative care | Causes of death unlikely to be suitable for palliative care (eg, accidental deaths). Individuals with no contact address |
People with dementia as underlying or contributing cause of death/total sample | 27/245 | 22/80 | 97/443 |
Item (Source) | Cost per Unit (£) | Unit in Source | Year From Source | Unit in Survey | Cost per Unit in Survey (£) | Adjusted for Inflation (£) | Method |
---|---|---|---|---|---|---|---|
Hospital care | |||||||
Inpatient hospital | 757 | Days | 2018-2019 | Days | 757 | 778.0 |
Median of the national average unit costs per day for all HRG codes by section, excluding pediatric services and transplant codes: |
ICU | 1534 | Days | 2018-2019 | Days | 1534 | 1576.6 | Critical care section; median of the national average unit costs for all service codes. |
AE | 110 | Visits | 2018-2019 | Events | 110.0 | 113.0 | Emergency medicine section; median of the national average unit costs for all service codes, excluding pediatric services |
Ambulance | 115 | Visits | 2018-2019 | Events | 115 | 118.2 | Ambulance section NHS reference costs; median of all activity descriptions |
Outpatient | 146 | Visits | 2018-2019 | Events | 145.5 | 149.5 | Outpatient attendance data; median of the national average unit costs for all service codes, excluding pediatric services |
Hospice | 450 | Days | 2012 | Days | 450.0 | 510.3 | Information on section “Inpatient Hospice Care” |
Nursing home | 907 | Weeks | 2019-2020 | Days | 129.6 | 129.6 | Information in section 1 (Services for Older People Age 65+); establishment cost plus personal living expenses and external services per permanent resident per week |
Residential | 1026.5 | Weeks | 2019-2020 | Days | 146.6 | 146.6 | Information in section 1 (Services for Older People Age 65+); median of private and LA establishment; establishment cost plus personal living expenses and external services per permanent resident week |
Day care | 64 | Days | 2019-2020 | Events | 64.0 | 64.0 | Information in section 1 (Services for Older People Age 65+); cost per attendance, including capital costs and total expenditures |
Nurses | |||||||
District nurses | 89 | Hours | 2019-2020 | Events | 44.5 | 44.5 | Information in section 10.1 (Nurses); band 6 cost per hour of patient-related work; assuming 30 min per contact |
Marie Curie nurses | 89 | Hours | 2019-2020 | Events | 44.5 | 44.5 | Information in section 10.1 (Nurses); band 6 cost per hour of patient-related work; assuming 30 min per contact |
McMillan nurses | 89 | Hours | 2019-2020 | Events | 44.5 | 44.5 | Information in section 10.1 (Nurses); band 6 cost per hour of patient-related work; assuming 30 min per contact |
Other nurses | 63 | Hours | 2019-2020 | Events | 31.5 | 31.5 | Information in section 10.1 (Nurses); band 5 cost per hour of patient-related work; assuming 30 min per contact |
Nurse practitioner | 120 | Hours | 2019-2020 | Events | 60.0 | 60.0 | Information in section 10.1 (Nurses); band 7 cost per hour of patient-related work; assuming 30 min per contact |
GP | |||||||
GP face-to-face contact | 33 | Per contact | 2019-2020 | Events | 33.0 | 33.0 | Information in section 10.3b (General Practitioner—Unit Costs); per surgery consultation lasting 9.22 min, including direct care staff costs without qualification costs |
GP telephone contact | 8.41 | Per contact | 2019-2020 | Events | 8.4 | 8.4 | Information in section 10.4 (The Cost of Online Consultations); average cost per GP telephone calls data |
Physiotherapist | 58 | Hours | 2019-2020 | Events | 29.0 | 29.0 | Information in section 9 (Scientific and Professional Staff); median cost per working hour for bands 4-8c, assuming 1 h per contact |
Occupational therapist | 58 | Hours | 2019-2020 | Events | 29.0 | 29.0 | Information in section 9 (Scientific and Professional Staff); median cost per working hour for bands 4-8c, assuming 1 h per contact |
Palliative care | 186.3 | Per contact | 2018-2019 | Events | 186.3 | 191.5 | National average unit cost for service code 315 (Palliative medicine) from the Outpatient NHS Reference Cost publication |
Psychiatrist | 246 | Sessions | 2018-2019 | Events | 246.1 | 252.9 | National average unit cost for service code 710 (Adult mental illness) from the Outpatient NHS Reference Cost publication |
Psychologist | 105 | Hours | 2019-2020 | Events | 105.0 | 105.0 | Information in section 9 (Scientific and Professional Staff); median cost per working hour for bands 8c-8d, assuming 1 h per contact |
Spiritual care | 522.9 | Weeks | 2020 | Events | 13.9 | 13.9 | Information from the Agenda for Change—pay rates in NHS; median wage band 5, assuming 37.5 working hours per week |
Other professionals | 146 | Visits | 2018-2019 | Events | 145.5 | 149.5 | Median of the national average unit costs for all service codes from the Outpatient NHS Reference Cost publication |
Social care | |||||||
Social worker | 45 | Hours | 2019-2020 | Events | 45.0 | 45.0 | Information in section 11.1 (Social Worker, Adult Services); cost per hour (excluding qualifications), assuming 1 h per contact |
Paid carer | 30 | Hours | 2019-2020 | hpw | 30 | 30.0 | Information in section 11.5 (Home Care Worker); median cost per hour for face-to-face contacts during weekdays day and nighttime, and withing weekends day and nighttime; the cost is based on the price multipliers for independent sector home care provided for private purchasers |
Indirect costs | |||||||
Personal care | 30 | Hours | 2020 | hpw | 30.0 | 30.0 | Information in section 11.5 (Home Care Worker); median cost per hour for face-to-face contacts during weekdays day- and nighttime, and withing weekends day- and nighttime; the cost is based on the price multipliers for independent sector home care provided for private purchasers |
Medical procedures | 39 | Hours | 2020 | hpw | 39.0 | 39.0 | Information in section 10.1 (Nurses); band 5 cost per working hour |
Appointment | 13.68 | Hours | 2020 | hpw | 13.68 | 13.68 | Information from the ASHE from ONS; median hourly earnings (£) |
Household | 13.68 | Hours | 2020 | hpw | 13.68 | 13.68 | Information from the ASHE from ONS; median hourly earnings (£) |
On-call | 13.68 | Hours | 2020 | hpw | 13.68 | 13.68 | Information from the ASHE from ONS; median hourly earnings (£) |
Time spent with patient | 13.68 | Hours | 2020 | hpw | 13.68 | 13.68 | Information from the ASHE from ONS; median hourly earnings (£) |
Total Costs (n = 143) | Formal Costs (n = 143) | Indirect Costs (n = 143) | |||||||
---|---|---|---|---|---|---|---|---|---|
Coefficient | SE | P Value | Coefficient | SE | P Value | Coefficient | SE | P Value | |
Transitions to hospital (ref: no) | |||||||||
Yes | 0.333 | 0.138 | .016 | 0.695 | 0.141 | <.001 | 0.076 | 0.408 | .85 |
Age | −0.006 | 0.011 | .60 | 0.014 | 0.011 | .22 | −0.023 | 0.031 | .46 |
Marital status (ref: married or with partner) | |||||||||
Widowed, divorced, or single | −0.143 | 0.185 | .44 | 0.093 | 0.170 | .59 | −0.468 | 0.532 | .38 |
Financial status (ref: living comfortably or doing alright) | |||||||||
Just about getting by | 0.060 | 0.174 | .73 | −0.021 | 0.163 | .90 | 0.295 | 0.508 | .56 |
Finding it quite or very difficult | 0.196 | 0.255 | .44 | −0.018 | 0.251 | .94 | 0.142 | 0.719 | .84 |
Having a key contact (ref: no) | |||||||||
Yes | −0.145 | 0.138 | .30 | −0.052 | 0.148 | .73 | −0.195 | 0.380 | .61 |
Gender (ref: male) | |||||||||
Female | 0.115 | 0.165 | .48 | 0.038 | 0.160 | .81 | 0.159 | 0.464 | .73 |
Place of care (ref: home) | |||||||||
Care home | −0.575 | 0.153 | <.001 | 0.300 | 0.143 | .036 | −1.613 | 0.449 | <.001 |
Proximity to death discussed (ref: no) | |||||||||
Yes | 0.222 | 0.139 | .11 | 0.092 | 0.139 | .51 | 0.347 | 0.392 | .38 |
EQ5D index | −0.285 | 0.511 | .58 | 0.266 | 0.510 | .60 | −0.674 | 1.451 | .64 |
IARE-I | 0.432 | 0.171 | .011 | 0.165 | 0.173 | .34 | 0.895 | 0.483 | .06 |
IARE-II | 0.118 | 0.228 | .60 | 0.122 | 0.227 | .59 | 0.216 | 0.613 | .72 |
Total Costs, All Sample (n = 143) | Total Costs for People Living at Home (n = 58) | Total Costs for People Living in Residential Care (n = 85) | |||||||
---|---|---|---|---|---|---|---|---|---|
Coefficient | SE | P Value | Coefficient | SE | P Value | Coefficient | SE | P Value | |
Transitions to hospital (ref: no) | |||||||||
Yes | 0.333 | 0.138 | .016 | 0.399 | 0.185 | .031 | 0.306 | 0.193 | .112 |
Age | −0.006 | 0.011 | .593 | 0.008 | 0.012 | .480 | −0.014 | 0.017 | .397 |
Marital status (ref: married or with partner) | |||||||||
Widowed, divorced, or single | −0.143 | 0.185 | .438 | −0.261 | 0.181 | .149 | 0.067 | 0.289 | .818 |
Financial status (ref: living comfortably or doing alright) | |||||||||
Just about getting by | 0.060 | 0.174 | .731 | 0.197 | 0.223 | .377 | 0.067 | 0.236 | .778 |
Finding it quite or very difficult | 0.196 | 0.255 | .442 | 0.387 | 0.315 | .219 | 0.174 | 0.371 | .640 |
Having a key contact (ref: no) | |||||||||
Yes | −0.145 | 0.138 | .293 | −0.137 | 0.159 | .389 | −0.172 | 0.207 | .406 |
Gender (ref: male) | |||||||||
Female | 0.115 | 0.165 | .484 | −0.008 | 0.203 | .969 | 0.088 | 0.238 | .712 |
Place of care (ref: home) | |||||||||
Care home | −0.575 | 0.153 | .000 | — | — | — | — | — | — |
Proximity to death discussed (ref: no) | |||||||||
Yes | 0.222 | 0.139 | .109 | 0.169 | 0.158 | .284 | 0.229 | 0.213 | .282 |
EQ5D index | −0.285 | 0.511 | .577 | −0.473 | 0.466 | .310 | −1.381 | 1.118 | .217 |
IARE-I | 0.432 | 0.171 | .011 | 0.306 | 0.181 | .090 | 0.580 | 0.279 | .038 |
IARE-II | 0.118 | 0.228 | .603 | 0.088 | 0.216 | .684 | −0.871 | 0.640 | .174 |
Total Costs, All Sample (n = 92) | Total Costs for People Living at Home (n = 32) | Total Costs for People Living in Residential Care (n = 60) | |||||||
---|---|---|---|---|---|---|---|---|---|
Coefficient | SE | P Value | Coefficient | SE | P Value | Coefficient | SE | P Value | |
Transitions to hospital (ref: no) | |||||||||
Yes | 0.294 | 0.186 | .11 | 0.622 | 0.318 | .05 | 0.245 | 0.245 | .32 |
Age | −0.011 | 0.016 | .50 | −0.021 | 0.026 | .42 | −0.016 | 0.022 | .47 |
Marital status (ref: married or with partner) | |||||||||
Widowed, divorced, or single | −0.072 | 0.241 | .77 | −0.331 | 0.289 | .25 | 0.145 | 0.357 | .68 |
Financial status (ref: living comfortably or doing alright) | |||||||||
Just about getting by | 0.208 | 0.256 | .42 | 0.737 | 0.476 | .12 | 0.202 | 0.313 | .52 |
Finding it quite or very difficult | −0.009 | 0.505 | .99 | 0.074 | 0.559 | .90 | |||
Having a key contact (ref: no) | |||||||||
Yes | −0.221 | 0.183 | .23 | −0.204 | 0.240 | .40 | −0.255 | 0.252 | .31 |
Gender (ref: male) | |||||||||
Female | 0.172 | 0.224 | .44 | 0.855 | 0.516 | .10 | 0.045 | 0.283 | .87 |
Place of care (ref: home) | |||||||||
Care home | −0.604 | 0.217 | .005 | — | — | — | — | — | — |
Proximity to death discussed (ref: no) | |||||||||
Yes | 0.287 | 0.194 | .14 | 0.101 | 0.259 | .70 | 0.323 | 0.264 | .22 |
EQ5D index | −0.352 | 0.705 | .62 | 0.398 | 0.791 | .61 | −2.059 | 1.377 | .14 |
IARE-I | 0.338 | 0.247 | .17 | −0.077 | 0.367 | .84 | 0.497 | 0.358 | .17 |
IARE-II | 0.065 | 0.312 | .84 | 0.139 | 0.387 | .72 | −0.962 | 0.786 | .22 |
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Article info
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Footnotes
Funding sources: J.L. is funded by a Royal Marsden Partners Pan London Research Fellowship Award and the Programa Formacion de Capital Humano Avanzado, Doctorado Becas Chile, 2018 (folio 72190265). D.Y. is supported by Cicely Saunders International. K.E.S is the Laing Galazka Chair in Palliative Care at King's College London, funded by an endowment from Cicely Saunders International and the Kirby Laing Foundation. I.J.H. is an NIHR Senior Investigator Emeritus. I.J.H. is supported by the NIHR Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. I.J.H. leads the Palliative and End of Life Care theme of the NIHR ARC South London, and co-leads the national theme in this. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care, or the funding charities.
The authors declare no conflicts of interest.
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