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Patterns of health care use and expenditure during the last 6 months of life in Belgium: Differences between age categories in cancer and non-cancer patients

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  • Gielen, Birgit
  • Remacle, Anne
  • Mertens, Raf

Abstract

Objectives We analysed end-of-life care in Belgium to examine potential age variation in place of death, transitions between care settings, health care utilisation and public expenditure in the last 6 months of life.Methods Administrative data of one sickness fund were used, and analysed through regression analysis and analysis of variance. The study population comprised 40,794 individuals (age > 40 years).Results Several indicators showed that the end-of-life of older people, especially of those aged >=90 years, differs from that of younger individuals. Older persons more likely died in a care home, were less transferred between care settings, and stayed less days in hospital. On the other hand, older persons used more home care services, and had more contacts with the general practitioner. Differences between age categories were equally observed for last week's end-of-life care. Opposite to the trend for cancer patients, the odds of having a palliative home care allowance increased with age for non-cancer patients. Public expenditure for the oldest old was lower as compared to the younger decedents, but dependent on place of death.Conclusion Several aspects of end-of-life care in Belgium appear to be influenced by age. In view of ageing of the population, these findings can be of interest to decision makers.

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  • Gielen, Birgit & Remacle, Anne & Mertens, Raf, 2010. "Patterns of health care use and expenditure during the last 6 months of life in Belgium: Differences between age categories in cancer and non-cancer patients," Health Policy, Elsevier, vol. 97(1), pages 53-61, September.
    • Handle: RePEc:eee:hepoli:v:97:y:2010:i:1:p:53-61
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    2. Caroline Bähler & Roland Rapold & Andri Signorell & Oliver Reich & Radoslaw Panczak & Eva Blozik, 2020. "Regional differences in healthcare costs at the end of life: an observational study using Swiss insurance claims data," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(6), pages 969-979, July.
    3. Cohen-Mansfield, Jiska & Skornick-Bouchbinder, Michal & Hoshen, Moshe & Brill, Shai, 2017. "The relationship between health services standardized costs and mortality is non-linear: Results from a large HMO population," Health Policy, Elsevier, vol. 121(9), pages 1008-1014.
    4. Hamblin, Richard & Minko, Nikolai & Shuker, Carl & Hill, Jennifer & Merry, Alan F., 2018. "What happens at the end of life? Using linked administrative health data to understand healthcare usage in the last year of life in New Zealand," Health Policy, Elsevier, vol. 122(7), pages 783-790.
    5. Caroline Bähler & Roland Rapold & Andri Signorell & Oliver Reich & Radoslaw Panczak & Eva Blozik, 0. "Regional differences in healthcare costs at the end of life: an observational study using Swiss insurance claims data," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 0, pages 1-11.
    6. Audrey Tanguy-Melac & Dorian Verboux & Laurence Pestel & Anne Fagot-Campagna & Philippe Tuppin & Christelle Gastaldi-Ménager, 2021. "Evolution of health care utilization and expenditure during the year before death in 2015 among people with cancer: French snds-based cohort study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(7), pages 1039-1052, September.
    7. Rolden, Herbert J.A. & van Bodegom, David & Westendorp, Rudi G.J., 2014. "Variation in the costs of dying and the role of different health services, socio-demographic characteristics, and preceding health care expenses," Social Science & Medicine, Elsevier, vol. 120(C), pages 110-117.

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