Healthcare Costs at the End of Life for Patients with Non-cancer Diseases and Cancer in Denmark

Anne Høy Seemann Vestergaard; Lars Holger Ehlers; Mette Asbjoern Neergaard; Christian Fynbo Christiansen; Jan Brink Valentin; Søren Paaske Johnsen

doi:10.1007/s41669-023-00430-1

Healthcare Costs at the End of Life for Patients with Non-cancer Diseases and Cancer in Denmark

Anne Høy Seemann Vestergaard^*, Lars Holger Ehlers, Mette Asbjoern Neergaard, Christian Fynbo Christiansen, Jan Brink Valentin, Søren Paaske Johnsen

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Objectives: To examine costs of care from a healthcare sector perspective within 1 year before death in patients with non-cancer diseases and patients with cancer. Methods: This nationwide registry-based study identified all Danish citizens dying from major non-cancer diseases or cancer in 2010–2016. Applying the cost-of-illness method, we included costs of somatic hospitals, including hospital-based specialist palliative care, primary care, prescription medicine and hospice expressed in 2022 euros. Costs of patients with non-cancer diseases and cancer were compared using regression analyses adjusting for sex, age, comorbidity, residential region, marital/cohabitation status and income level. Results: Within 1 year before death, mean total healthcare costs were €27,185 [95% confidence interval (CI) €26,970–27,401] per patient with non-cancer disease (n = 109,723) and €51,348 (95% CI €51,098–51,597) per patient with cancer (n = 108,889). The adjusted relative total healthcare costs, i.e. the ratio of the mean costs, of patients with non-cancer diseases was 0.64 (95% CI 0.63–0.66) at 12 months before death and 0.91 (95% CI 0.90–0.92) within 30 days before death compared with patients with cancer. Mean costs of hospital-based specialist palliative care and hospice in the year leading up to death were €17 (95% CI €13–20) and €90 (95% CI €77–102) per patient with non-cancer disease but €1552 (95% CI €1506–1598) and €3411 (95% CI €3342–3480) per patient with cancer. Conclusions: Within 1 year before death, total healthcare costs, mainly driven by hospital costs, were substantially lower for patients with non-cancer diseases compared with patients with cancer. Moreover, the costs of hospital-based specialist palliative care and hospice were minimal for patients with non-cancer diseases.

Original language	English
Journal	PharmacoEconomics - Open
Volume	7
Issue	5
Pages (from-to)	751-764
Number of pages	14
ISSN	2509-4262
DOIs	https://doi.org/10.1007/s41669-023-00430-1
Publication status	Published - Sept 2023

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10.1007/s41669-023-00430-1

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@article{c03e94bbe7fb403a9fe745eaf395d3c4,

title = "Healthcare Costs at the End of Life for Patients with Non-cancer Diseases and Cancer in Denmark",

abstract = "Objectives: To examine costs of care from a healthcare sector perspective within 1 year before death in patients with non-cancer diseases and patients with cancer. Methods: This nationwide registry-based study identified all Danish citizens dying from major non-cancer diseases or cancer in 2010–2016. Applying the cost-of-illness method, we included costs of somatic hospitals, including hospital-based specialist palliative care, primary care, prescription medicine and hospice expressed in 2022 euros. Costs of patients with non-cancer diseases and cancer were compared using regression analyses adjusting for sex, age, comorbidity, residential region, marital/cohabitation status and income level. Results: Within 1 year before death, mean total healthcare costs were €27,185 [95% confidence interval (CI) €26,970–27,401] per patient with non-cancer disease (n = 109,723) and €51,348 (95% CI €51,098–51,597) per patient with cancer (n = 108,889). The adjusted relative total healthcare costs, i.e. the ratio of the mean costs, of patients with non-cancer diseases was 0.64 (95% CI 0.63–0.66) at 12 months before death and 0.91 (95% CI 0.90–0.92) within 30 days before death compared with patients with cancer. Mean costs of hospital-based specialist palliative care and hospice in the year leading up to death were €17 (95% CI €13–20) and €90 (95% CI €77–102) per patient with non-cancer disease but €1552 (95% CI €1506–1598) and €3411 (95% CI €3342–3480) per patient with cancer. Conclusions: Within 1 year before death, total healthcare costs, mainly driven by hospital costs, were substantially lower for patients with non-cancer diseases compared with patients with cancer. Moreover, the costs of hospital-based specialist palliative care and hospice were minimal for patients with non-cancer diseases.",

author = "Vestergaard, {Anne H{\o}y Seemann} and Ehlers, {Lars Holger} and Neergaard, {Mette Asbjoern} and Christiansen, {Christian Fynbo} and Valentin, {Jan Brink} and Johnsen, {S{\o}ren Paaske}",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = sep,

doi = "10.1007/s41669-023-00430-1",

language = "English",

volume = "7",

pages = "751--764",

journal = "PharmacoEconomics - Open",

issn = "2509-4262",

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Healthcare Costs at the End of Life for Patients with Non-cancer Diseases and Cancer in Denmark. / Vestergaard, Anne Høy Seemann; Ehlers, Lars Holger; Neergaard, Mette Asbjoern et al.
In: PharmacoEconomics - Open, Vol. 7, No. 5, 09.2023, p. 751-764.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Healthcare Costs at the End of Life for Patients with Non-cancer Diseases and Cancer in Denmark

AU - Vestergaard, Anne Høy Seemann

AU - Ehlers, Lars Holger

AU - Neergaard, Mette Asbjoern

AU - Christiansen, Christian Fynbo

AU - Valentin, Jan Brink

AU - Johnsen, Søren Paaske

PY - 2023/9

Y1 - 2023/9

N2 - Objectives: To examine costs of care from a healthcare sector perspective within 1 year before death in patients with non-cancer diseases and patients with cancer. Methods: This nationwide registry-based study identified all Danish citizens dying from major non-cancer diseases or cancer in 2010–2016. Applying the cost-of-illness method, we included costs of somatic hospitals, including hospital-based specialist palliative care, primary care, prescription medicine and hospice expressed in 2022 euros. Costs of patients with non-cancer diseases and cancer were compared using regression analyses adjusting for sex, age, comorbidity, residential region, marital/cohabitation status and income level. Results: Within 1 year before death, mean total healthcare costs were €27,185 [95% confidence interval (CI) €26,970–27,401] per patient with non-cancer disease (n = 109,723) and €51,348 (95% CI €51,098–51,597) per patient with cancer (n = 108,889). The adjusted relative total healthcare costs, i.e. the ratio of the mean costs, of patients with non-cancer diseases was 0.64 (95% CI 0.63–0.66) at 12 months before death and 0.91 (95% CI 0.90–0.92) within 30 days before death compared with patients with cancer. Mean costs of hospital-based specialist palliative care and hospice in the year leading up to death were €17 (95% CI €13–20) and €90 (95% CI €77–102) per patient with non-cancer disease but €1552 (95% CI €1506–1598) and €3411 (95% CI €3342–3480) per patient with cancer. Conclusions: Within 1 year before death, total healthcare costs, mainly driven by hospital costs, were substantially lower for patients with non-cancer diseases compared with patients with cancer. Moreover, the costs of hospital-based specialist palliative care and hospice were minimal for patients with non-cancer diseases.

AB - Objectives: To examine costs of care from a healthcare sector perspective within 1 year before death in patients with non-cancer diseases and patients with cancer. Methods: This nationwide registry-based study identified all Danish citizens dying from major non-cancer diseases or cancer in 2010–2016. Applying the cost-of-illness method, we included costs of somatic hospitals, including hospital-based specialist palliative care, primary care, prescription medicine and hospice expressed in 2022 euros. Costs of patients with non-cancer diseases and cancer were compared using regression analyses adjusting for sex, age, comorbidity, residential region, marital/cohabitation status and income level. Results: Within 1 year before death, mean total healthcare costs were €27,185 [95% confidence interval (CI) €26,970–27,401] per patient with non-cancer disease (n = 109,723) and €51,348 (95% CI €51,098–51,597) per patient with cancer (n = 108,889). The adjusted relative total healthcare costs, i.e. the ratio of the mean costs, of patients with non-cancer diseases was 0.64 (95% CI 0.63–0.66) at 12 months before death and 0.91 (95% CI 0.90–0.92) within 30 days before death compared with patients with cancer. Mean costs of hospital-based specialist palliative care and hospice in the year leading up to death were €17 (95% CI €13–20) and €90 (95% CI €77–102) per patient with non-cancer disease but €1552 (95% CI €1506–1598) and €3411 (95% CI €3342–3480) per patient with cancer. Conclusions: Within 1 year before death, total healthcare costs, mainly driven by hospital costs, were substantially lower for patients with non-cancer diseases compared with patients with cancer. Moreover, the costs of hospital-based specialist palliative care and hospice were minimal for patients with non-cancer diseases.

U2 - 10.1007/s41669-023-00430-1

DO - 10.1007/s41669-023-00430-1

M3 - Journal article

C2 - 37552432

AN - SCOPUS:85167337428

SN - 2509-4262

VL - 7

SP - 751

EP - 764

JO - PharmacoEconomics - Open

JF - PharmacoEconomics - Open

IS - 5

ER -

Healthcare Costs at the End of Life for Patients with Non-cancer Diseases and Cancer in Denmark

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