title: The use of healthcare resources in the last 3 years of life in patients with COPD and lung cancer in Denmark. A retrospective nationwide study.
abstract: OBJECTIVE
  The aim was to describe the use of healthcare resources during the last 3 years of life in patients who died from chronic obstructive pulmonary disease (COPD) or lung cancer (LC), including patients with LC and COPD.
  
  
  METHODS
  Using data from Danish health registers, we identified 6648 individuals who, in 2010, died from COPD (n=3013) and LC (n=3635), including 775 from LC and COPD.
  
  
  RESULTS
  Patients with COPD and LC had a high use of services in the last 3 years of life, but the trajectory for COPD was different from that of LC. Fifty-five per cent of subjects with LC received a reimbursement for the terminally ill compared to only 4% of subjects with COPD (p<0.0001). There was a significant increase in the number of individuals with COPD who received non-invasive ventilation (NIV) for the first time in the last 6 months of life. Individuals with COPD and LC had the highest consumption of health resources.
  
  
  CONCLUSIONS
  The high use of health resources together with the underuse of economic reimbursement in patients with terminal COPD suggest that more focus should be given to these patients. The need for NIV might be an indicator of poor prognosis and reflect an intensified need for palliative care. The high use of healthcare resources in patients with COPDandLC might indicate a substantial need for palliative care in these patients.
authors.affiliation: Danish Lung Association, Copenhagen, Denmark.
authors.forename: Marie Gade
authors.initials: MG
authors.lastname: Husted
authors.affiliation: Section of Health Services Research, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Margit
authors.initials: M
authors.lastname: Kriegbaum
authors.affiliation: Danish Lung Association, Copenhagen, Denmark.
authors.forename: Nicolai
authors.initials: N
authors.lastname: Kirkegaard
authors.affiliation: Department of Public Health, Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.|Respiratory Section, Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Lange