[Care costs and activity in the last three months of life of cancer patients who died in the Basque Country (Spain)]

Abstract

Objective: To analyse the use of health resources and its budget in the last months of life of the population who died from malignant neoplasm in the Basque Autonomous Country (Spain).

Method: Retrospective observational study of a population with a diagnosis of malignancy deceased in the Basque Country (2010 and 2011).

Data source: MDS and Mortality Register.

Variables: gender, age, place of death, tumour location, clinical activity data and costs in the last three months of life. We performed a descriptive analysis of clinical activity and costs, and lineal multivariate regressions to obtain the adjusted mean costs by gender, age and place of death.

Results: 9,333 deaths from malignancy were identified in 2010 and 2011. 65.4% were men, 61.5% aged 70 or over, mean age 72.9 years, 71.1% died in hospital. People who died in the hospital had an average cost of about double that of the people who died at home (€14,794 and €7,491, respectively; p <0.001) and 31.3% higher than in the nursing home (€11,269; p <0.001).

Conclusions: Greater interventions at the end of life at the community level are necessary, strengthening the care capacity of primary health care, both from training and support from expert teams in order to change the current care profile to a more outpatient care that allows a lower consumption of resources and greater care at home.

Keywords: Análisis de coste; Cost analysis; Cuidados paliativos; Cáncer; Neoplasms; Palliative care; Public health; Salud pública.