April 2014

Palliat Med. 2013 Dec 23. [Epub ahead of print]

Economic impact of hospitalisations among patients in the last year of life: An observational study

Gardiner C, Ward S, Gott M, Ingleton C

In this observational retrospective study in two English hospitals, 483 patients who died within 1 year of admission to hospital, had their case notes reviewed by palliative medicine consultants to determine if the admission was potentially avoidable. The economic impact of these admissions was also evaluated. From the 483 hospital admissions of patients in the last year of life, 35 (7.2%) were thought to be potentially avoidable, by direct admission to an alternative place of care, principally a nursing home. Avoiding these admissions and caring for the patients in alternative locations would be compatible with patient preferences and would have saved the two hospitals nearly £6 million per year. However, if the length of stay in all 483 patients was reduced by 14%, the two hospitals could save nearly £50 million per year. These savings would partly be decreased by increased costs for care in the community, for which accurate cost data were not available.

Jason Boland