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Palliative Medicine
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Taking care of terminally-ill patients at home — the economic perspective revisited

Oren Tamir

Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, popcorn{at}bgu.ac.il

Yoram Singer

Palliative Care Unit, Ben-Gurion University of the Negev and Clalit Health Services-South District, Beer-Sheva

Pesach Shvartzman

Family Medicine Department and Siaal Family Medicine and Primary Care Research Center, Ben-Gurion University of the Negev and Clalit Health Services — South District, Beer-Sheva

End-of-life care can be delivered in a variety of settings, whereby the majority of terminally-ill cancer patients prefer to die at home. The aim of our study is to evaluate health services utilisation during the last year of life, and to compare terminally ill patients who have received home-specialised palliative care services (HSPCS) with patients who died receiving home non-specialised palliative care services. The study included 120 and 515 patients, respectively, who died between 1999—2000. Age and gender distribution were similar in both groups. During the last year of life, mean health services cost per person among the HSPCS group was lower by more then 30% (P < 0.005). The median cost per patient was as low as one-fifth in the last month. Men and the older age group of 65 and above, cost significantly less compared with women and younger patients, respectively, regardless of provider setting. The main differences in health services utilisation were in hospitalisations and oncology treatments (P < 0.01 and P < 0.05, respectively). Palliative Medicine 2007; 21 : 537—541

Key Words: homecare • hospice • palliative care • terminal patients • utilisation

Palliative Medicine, Vol. 21, No. 6, 537-541 (2007)
DOI: 10.1177/0269216307080822
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[Abstract] [PDF]