End-of-life care accounts for 10 per cent of health budgets, study finds

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This article was published 8/4/2015 (862 days ago), so information in it may no longer be current.

An average person will rack up a $14,000 tab as he or she spends the final month of life in a hospital bed.

That sizeable figure comes from an Ontario-based study that looked into what the actual health-care costs are when an average person spends his or her final 30 days receiving acute care inside a medical facility.

The study, put together by physicians from the Universities of Toronto and Ottawa, examined health-care and patient data in Ontario from 2010 to 2013. The group discovered nearly $5 billion annually is spent on the care of people in their last year of life (10 per cent of the overall health budget). Included in their findings was a huge end-of-life total: $1.3 billion spent on patients living out the last month of their lives.

Dr. Peter Tanuseputro, research fellow at the Bruyère Research Institute and the Ottawa Hospital Research Institute, said while the research paints an ominous portrait of future health-care costs, the link between those costs and quality health care may change over time.

"The majority of costs are really driven by acute-care costs, people being admitted to hospital in the last three to four months of their life," said Tanuseputro, who co-authored the study. "If we increase the reach of palliative care that occurs in the home, many of those hospitalizations can be prevented, and in many cases, the same quality of care can be provided.

"Limiting the amount of hospital time is a desirable outcome for patients and their families."

The study, published in the journal PLOS One last month, looked at Ontario data. Given the stresses on health-care systems across the country and the aging baby boomer population turning to those services more frequently, it’s not just an Ontario issue.

"That’s the reality we face everywhere," offered Verena Menec, Canada research chair in health aging at the University of Manitoba. "As hospital care increases, so do the costs, and end-of-life care is certainly a big part of that. How much of that can we reduce, knowing that there will always be a percentage of the population that will die in a hospital?"

With acute-care treatment solutions measured against comfort concerns, more families are faced with tough decisions regarding their aging loved ones. Menec said some of those choices are made easier in Manitoba with hospital-based palliative care units, which have proven to be effective in terms of relieving health-care system stress and providing care for patients.

Menec said not everyone can live out their lives at home. Sometimes an illness or condition makes the choice for people, whether they like it or not.

"The majority of people will say they would like to die at home," she said. "Realistically, is that possible? Some people can die there, stay in the comfort of their home right to the end. In some cases, people might need to be treated at hospital. Is the home the best place for a 90-year-old person with mobility issues? Maybe not. Situations can change rapidly at that stage."

Tanuseputro said provinces need to start focusing on increased palliative and home care to help manage the end-of-life health-care cost. It’s a policy tweak that needs to happen soon, given the expected generational stresses on the health-care system.

"Admissions could be reduced by providing additional palliative care in the home," he said.

The Winnipeg Regional Health Authority would not comment on the Ontario study, citing The Pas byelection and the province’s Elections Finances Act, which restricts advertisements and publications (including media requests) by Crown agencies during the byelection period.

adam.wazny@freepress.mb.ca