title: Terminal patients in Belgian nursing homes: a cost analysis.
abstract: Policy makers and health care payers are concerned about the costs of treating terminal patients. This study was done to measure the costs of treating terminal patients during the final month of life in a sample of Belgian nursing homes from the health care payer perspective. Also, this study compares the costs of palliative care with those of usual care. This multicenter, retrospective cohort study enrolled terminal patients from a representative sample of nursing homes. Health care costs included fixed nursing home costs, medical fees, pharmacy charges, other charges, and eventual hospitalization costs. Data sources consisted of accountancy and invoice data. The analysis calculated costs per patient during the final month of life at 2007/2008 prices. Nineteen nursing homes participated in the study, generating a total of 181 patients. Total mean nursing home costs amounted to 3,243 € per patient during the final month of life. Total mean nursing home costs per patient of 3,822 € for patients receiving usual care were higher than costs of 2,456 € for patients receiving palliative care (p = 0.068). Higher costs of usual care were driven by higher hospitalization costs (p < 0.001). This study suggests that palliative care models in nursing homes need to be supported because such care models appear to be less expensive than usual care and because such care models are likely to better reflect the needs of terminal patients.
authors.affiliation: Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven, Leuven, Belgium. steven.simoens@pharm.kuleuven.be
authors.forename: Steven
authors.initials: S
authors.lastname: Simoens
authors.forename: Betty
authors.initials: B
authors.lastname: Kutten
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Keirse
authors.forename: Paul
authors.initials: P
authors.lastname: Vanden Berghe
authors.forename: Claire
authors.initials: C
authors.lastname: Beguin
authors.forename: Marianne
authors.initials: M
authors.lastname: Desmedt
authors.forename: Myriam
authors.initials: M
authors.lastname: Deveugele
authors.forename: Christian
authors.initials: C
authors.lastname: Léonard
authors.forename: Dominique
authors.initials: D
authors.lastname: Paulus
authors.forename: Johan
authors.initials: J
authors.lastname: Menten
mesh_terms: D000368:Aged; D001530:Belgium; D003365:Costs and Cost Analysis; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006707:Homes for the Aged / Q000191:economics*; D006801:Humans; D009735:Nursing Homes / Q000191:economics*; D010166:Palliative Care / Q000191:economics*; D012189:Retrospective Studies; D013727:Terminal Care / Q000191:economics*