Research & Development, The National Alliance of Christian Mutualities, Brussels, Belgium.
Health Policy. 2010 Sep;97(1):53-61. doi: 10.1016/j.healthpol.2010.03.002. Epub 2010 Mar 31.
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.
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).
Several indicators showed that the end-of-life of older people, especially of those aged >or=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.
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.
我们分析了比利时的临终关怀情况，以考察在生命的最后 6 个月中，死亡地点、护理环境之间的转换、医疗保健利用和公共支出方面是否存在潜在的年龄差异。
利用一个疾病基金的行政数据，通过回归分析和方差分析进行分析。研究人群包括 40794 人（年龄>40 岁）。
多项指标表明，老年人，尤其是年龄≥90 岁的老年人，其临终护理与年轻人不同。老年人更有可能在养老院去世，在护理环境之间的转移较少，在医院的住院天数也较少。另一方面，老年人更多地使用家庭护理服务，与全科医生的接触也更多。在生命最后一周的临终关怀方面，不同年龄组之间也存在同样的差异。与癌症患者的趋势相反，对于非癌症患者，接受姑息治疗家庭护理津贴的几率会随着年龄的增长而增加。与年轻死者相比，最年长的老年人的公共支出较低，但取决于死亡地点。
比利时临终关怀的几个方面似乎受到年龄的影响。鉴于人口老龄化，这些发现可能对决策者有意义。
