1. [Every week counts: Use of health services and related costs of a community-based cohort of people with advanced chronic diseases].
- Author
-
Blay C, Martori JC, Limon E, Lasmarías C, Oller R, and Gómez-Batiste X
- Subjects
- Aged, Cohort Studies, Humans, Severity of Illness Index, Time Factors, Chronic Disease therapy, Community Health Services economics, Facilities and Services Utilization economics, Facilities and Services Utilization statistics & numerical data, Health Care Costs, Palliative Care economics
- Abstract
Objective: To describe the use of health resources of people with advanced chronicity, quantifying and characterizing its cost to suggest improvements in health care models., Design: Observational, analytical and prospective study during 3 years of a cohort of people with advanced chronicity., Location: Three primary care teams (EAP) of Osona, Cataluña., Participants: 224 people identified as advanced patients through a systematic population strategy., Main Measurements: Age, sex, type of home, end-of-life trajectory; use, type and cost of resources in primary care, emergencies, palliative teams or hospitalization (in acute or intermediate care)., Results: Patients made an average of 1.1 admissions per year (average stay=6 days), 74% in intermediate care hospitals. They lived in the community 93.4% of time, carrying out 1 weekly contact with the EAP (45.1% home care). The average daily cost was 19.4euros, the main chapters were intermediate care hospitalizations (36.5%), EAP activity (29.4%) and admissions in acute hospitals (28.6%). Factors determining a potential lower cost are frailty/dementia as trajectory (p<0.001), living in a nursing-home facility (p<0.001) and over-aging (p<0.001). There are certain differences in the behavior of the EAP related to the global cost and to community resources (p<0.05)., Conclusions: Consumption in intermediate hospitalization and primary care is more relevant than stays in acute care centers. Nursing-homes and home-care strategies are important to attend effectively and efficiently, especially when primary care teams get ready for it., (Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF