1 Tuusula Health Care Centre, Tuusula, Finland.
2 Department of Public Health, University of Helsinki, Helsinki, Finland.
Palliat Med. 2018 Feb;32(2):493-499. doi: 10.1177/0269216317729789. Epub 2017 Sep 12.
Palliative care needs are increasing as more people are dying from incurable diseases. Healthcare costs have been reported to be highest during the last year of life, but studies on the actual costs of palliative care are scarce.
To explore the resource use and costs of palliative care among end-stage breast, colorectal and prostate cancer patients after termination of life-prolonging oncological treatments, that is, during the palliative care period.
A real-life longitudinal register- and questionnaire-based study of cancer patients' resource use and costs.
In total, 70 patients in palliative care with no ongoing oncological treatments were recruited from the Helsinki University Hospital or from the local hospice. Healthcare costs, productivity costs and informal care costs were included.
The mean duration of the palliative care period was 179 days. The healthcare cost accounted for 55%, informal care for 27% and productivity costs for 18% of the total costs. The last 2 weeks of life contributed to 37% of the healthcare cost. The costs of the palliative care period were higher in patients living alone, which was mostly caused by inpatient care ( p = 0.018).
The 45% share of indirect costs is substantial in end-of-life care. The healthcare costs increase towards death, which is especially true of patients living alone. This highlights the significant role of caregivers. More attention should be paid to home care and caregiver support to reduce inpatient care needs and control the costs of end-of-life care.
随着越来越多的人死于绝症，姑息治疗的需求正在增加。据报道，医疗保健费用在生命的最后一年最高，但关于姑息治疗实际成本的研究很少。
探讨在终止延长生命的肿瘤治疗后，即姑息治疗期间，终末期乳腺癌、结直肠癌和前列腺癌患者的姑息治疗资源利用和成本。
一项基于登记和问卷调查的癌症患者资源利用和成本的真实纵向研究。
共招募了 70 名来自赫尔辛基大学医院或当地临终关怀机构的无持续肿瘤治疗的姑息治疗患者。包括医疗保健费用、生产力成本和非正式护理成本。
姑息治疗期的平均持续时间为 179 天。医疗保健费用占 55%，非正式护理占 27%，生产力成本占 18%。生命的最后 2 周贡献了 37%的医疗保健费用。独居患者的姑息治疗期费用较高，这主要是由于住院治疗（p=0.018）。
在生命末期护理中，间接成本的 45%占比相当大。医疗保健费用随着死亡而增加，独居患者的情况更是如此。这突出了照顾者的重要作用。应更多关注家庭护理和照顾者支持，以减少住院护理需求并控制生命末期护理的成本。
