Economic impact of hospitalisations among patients in the last year of life: An observational study

Gardiner, Clare; Ward, Sue; Gott, Merryn; Ingleton, Christine

doi:10.1177/0269216313517284

Cited by 33 publications

(19 citation statements)

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“…In another study by Soria-Aledo et al to estimate inappropriate admissions employing AEP, this rate was equal to 7.4% (1). Several other investigations that did not use AEP for inappropriate admission estimation reported higher rates (14% -24%) than the current study (15,(20)(21)(22)(23). For instance, this rate was reported as 22% in a study by Eriksen et al in Norway (21).…”

Section: Discussioncontrasting

confidence: 57%

Evaluation of Inappropriate Admission and Hospitalization According to Appropriateness Evaluation Protocol and Estimation of Direct Financial Burden

et al. 2019

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Background: Appropriate allocation of resources is an important issue in the delivery of services that can reduce the health system costs. The inappropriateness of healthcare services is one of the problems that increase the pressure on hospitals and patients. Methods: In this study, the data were collected using the appropriateness evaluation protocol by a medicine specialist at Rasoul Akram Hospital. In total, 248 participants were selected through systematic sampling. To calculate the financial burden simultaneously with the evaluation of inappropriate hospitalization days, the medicine and facility costs along with the cost of bed-day were estimated. Data were analyzed by SPSS software. Results: The type of treatment was surgery in 56.8% of the patients and 43.2% of them were admitted to the hospital for internal medicine. The mean length of stay was 4 ± 6 days. The inappropriate admission rate was estimated at about 6% and the rate of inappropriate hospital stays was 21.5%. The most important factors influencing the inappropriateness of hospitalization were delayed medical consultations, delayed surgery, conservative practitioner, and the follow-up of clinical test results. The sum of the direct financial burden of inappropriate hospitalization for the patients was estimated at around 1060 dollars. Conclusions: The findings of this study indicated that inappropriate hospitalization and admission imposed a huge financial burden on the health system and community. Hospital authorities by considering issues such as delayed medical consultations and delayed surgery can decrease the financial burden of inappropriate hospitalization to a large extent.

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Section: Discussioncontrasting

confidence: 57%

Evaluation of Inappropriate Admission and Hospitalization According to Appropriateness Evaluation Protocol and Estimation of Direct Financial Burden

et al. 2019

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“…Hospitalization represents the principal component of cost in the last year of life (12) and research has concluded that avoiding hospital admissions could result in significant cost savings (13,14). A systematic review of the literature exploring experiences of palliative care in a hospital setting identified that hospital admissions can be burdensome for patients and families (15).…”

Section: Introductionmentioning

confidence: 99%

A qualitative study exploring the benefits of hospital admissions from the perspectives of patients with palliative care needs

et al. 2015

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Background: The acute hospital plays a significant role in caring for people with a life-limiting illness. Most research to date has focused exclusively upon the negative aspects of hospitalisation. Currently, there is little known about the benefits of hospital admissions for patients with palliative care needs. Aim: The aim of this study was to explore the benefits of hospital admissions, from the perspectives of patients with palliative care needs. Design: A qualitative study design was adopted. Longitudinal, semi-structured, face-to-face interviews were used to elicit the views of patients admitted to hospital in one large urban acute hospital in New Zealand. Setting/participants: The study sample comprised 14 patients admitted to Auckland City Hospital between July 2013 and March 2014 who met one of the Gold Standard Framework Prognostic Indicators for palliative care need. Results: Through a process of thematic analysis, four themes were identified from the data: being cared for and feeling safe, receiving care to manage at home, relief for family and ‘feeling better and/or getting better’. The benefits of being in hospital were reported to extend beyond treatments received. Most participants reported their preference was to come to hospital even if they had been able to access the care they received in hospital at home. Conclusion: This research contributes to a greater understanding of the benefits associated with hospitalisation for patients with palliative care needs. The findings suggest that such benefits extend beyond the treatment patients receive and challenge current assumptions regarding the role of the acute hospital in palliative care.

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“…One study found nearly a quarter of admissions of patients with palliative care needs were potentially avoidable 7. These admissions are also expensive: potentially avoidable admissions of people in the last year of life cost two hospitals in the North of England £5.9 million per year 8…”

Section: Discussionmentioning

confidence: 99%

Hospice advice and rapid response service for ambulance clinicians

Dent

Tipping

Anderson

et al. 2020

BMJ Support Palliat Care

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ObjectivePatients in the last year of life experience medical emergencies which may lead to an emergency attendance by ambulance clinicians and some patients having a transfer to hospital even when this is unwanted by patients, carers or professionals. Here we report the patient characteristics and outcomes of a 24-hour hospice nursing telephone advice service to support an ambulance service.MethodAn evaluation of the outcomes of ambulance calls to a nursing telephone advice service for people living in northwest London, UK, attended at home during a 6-month period by the London Ambulance Service, whose clinicians then sought advice from the hospice’s 24 hours’ telephone line.ResultsForty-five attendances of 44 acutely ill people with palliative care needs resulted in a telephone call. Thirteen patients (30%) were male and the median age was over 80 years. Thirty-two attendances (71%) were managed without a transfer to hospital, with telephone advice from the hospice and in some cases arrangements for another clinician to visit. Seven attendances (16%) resulted in a transfer to hospital, of which at least five led to an admission. Six attendances (13%) resulted in a notification of the patient’s death.ConclusionsThis preliminary study shows the feasibility, outcomes and acceptability of telephone advice to support ambulance clinicians attending patients with palliative care needs. The service was associated with low rates of subsequent transfer to hospital. Further controlled research is needed to assess the clinical and cost-effectiveness of the service.

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Economic impact of hospitalisations among patients in the last year of life: An observational study

Cited by 33 publications

References 10 publications

Evaluation of Inappropriate Admission and Hospitalization According to Appropriateness Evaluation Protocol and Estimation of Direct Financial Burden

Evaluation of Inappropriate Admission and Hospitalization According to Appropriateness Evaluation Protocol and Estimation of Direct Financial Burden

A qualitative study exploring the benefits of hospital admissions from the perspectives of patients with palliative care needs

Hospice advice and rapid response service for ambulance clinicians

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