Evolution of health care utilization and expenditure during the year before death in 2015 among people with cancer: French snds-based cohort study.
Administrative database
Cancer
End-of-life
France
Healthcare expenditure
Out-of-pocket
Journal
The European journal of health economics : HEPAC : health economics in prevention and care
ISSN: 1618-7601
Titre abrégé: Eur J Health Econ
Pays: Germany
ID NLM: 101134867
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
07
07
2020
accepted:
26
03
2021
pubmed:
9
6
2021
medline:
18
9
2021
entrez:
8
6
2021
Statut:
ppublish
Résumé
Cancer patients have one of the highest health care expenditures (HCE) at the end of life. However, the growth of HCE at the end of life remains poorly documented in the literature. To describe monthly reimbursed expenditure during the last year of life among cancer patients, by performing detailed analysis according to type of expenditure and the person's age. Data were derived from the Système national des données en santé (SNDS) [national health data system], which comprises information on ambulatory and hospital care. Analyses focused on general scheme beneficiaries (77% of the French population) treated for cancer who died in 2015. Average reimbursed expenditure during the last year of life was €34,300 per person in 2015, including €21,100 (62%) for hospital expenditure. "Short-stays hospital" and "rehabilitation units" stays expenditure were €14,700 and €2000, respectively. Monthly expenditure increased regularly towards the end of life, increasing from 12 months before death €2000 to €5200 1 month before death. The highest levels of expenditure did not concern the oldest people, as average reimbursed expenditure was €50,300 for people 18-59 years versus €25,600 for people 80-90 years. Out-of-pocket payments varied only slightly according to age, but increased towards the end of life. A marked growth of HCE was observed during the last 4 months of life, mainly driven by hospital expenditure, with a more marked growth for younger people.
Sections du résumé
BACKGROUND
BACKGROUND
Cancer patients have one of the highest health care expenditures (HCE) at the end of life. However, the growth of HCE at the end of life remains poorly documented in the literature.
OBJECTIVE
OBJECTIVE
To describe monthly reimbursed expenditure during the last year of life among cancer patients, by performing detailed analysis according to type of expenditure and the person's age.
METHOD
METHODS
Data were derived from the Système national des données en santé (SNDS) [national health data system], which comprises information on ambulatory and hospital care. Analyses focused on general scheme beneficiaries (77% of the French population) treated for cancer who died in 2015.
RESULTS
RESULTS
Average reimbursed expenditure during the last year of life was €34,300 per person in 2015, including €21,100 (62%) for hospital expenditure. "Short-stays hospital" and "rehabilitation units" stays expenditure were €14,700 and €2000, respectively. Monthly expenditure increased regularly towards the end of life, increasing from 12 months before death €2000 to €5200 1 month before death. The highest levels of expenditure did not concern the oldest people, as average reimbursed expenditure was €50,300 for people 18-59 years versus €25,600 for people 80-90 years. Out-of-pocket payments varied only slightly according to age, but increased towards the end of life.
CONCLUSION
CONCLUSIONS
A marked growth of HCE was observed during the last 4 months of life, mainly driven by hospital expenditure, with a more marked growth for younger people.
Identifiants
pubmed: 34100171
doi: 10.1007/s10198-021-01304-1
pii: 10.1007/s10198-021-01304-1
pmc: PMC8318964
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1039-1052Informations de copyright
© 2021. The Author(s).
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