International comparison of spending and utilization at the end of life for hip fracture patients.
Blankart, CR
van Gool, K
Papanicolas, I
Bernal-Delgado, E
Bowden, N
Estupiñán-Romero, F
Gauld, R
Knight, H
Abiona, O
Riley, K
Schoenfeld, AJ
Shatrov, K
Wodchis, WP
Figueroa, JF
ICCONIC Collaboration,
- Publisher:
- Wiley
- Publication Type:
- Journal Article
- Citation:
- Health Services Research, 2021, 56, (S3), pp. 1370-1382
- Issue Date:
- 2021-09-07
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Blankart, CR | |
dc.contributor.author | van Gool, K | |
dc.contributor.author | Papanicolas, I | |
dc.contributor.author | Bernal-Delgado, E | |
dc.contributor.author | Bowden, N | |
dc.contributor.author | Estupiñán-Romero, F | |
dc.contributor.author | Gauld, R | |
dc.contributor.author | Knight, H | |
dc.contributor.author |
Abiona, O https://orcid.org/0000-0002-1696-4475 |
|
dc.contributor.author | Riley, K | |
dc.contributor.author | Schoenfeld, AJ | |
dc.contributor.author | Shatrov, K | |
dc.contributor.author | Wodchis, WP | |
dc.contributor.author | Figueroa, JF | |
dc.contributor.author | ICCONIC Collaboration, | |
dc.date.accessioned | 2021-12-20T23:15:58Z | |
dc.date.available | 2021-07-08 | |
dc.date.available | 2021-12-20T23:15:58Z | |
dc.date.issued | 2021-09-07 | |
dc.identifier.citation | Health Services Research, 2021, 56, (S3), pp. 1370-1382 | |
dc.identifier.issn | 0017-9124 | |
dc.identifier.issn | 1475-6773 | |
dc.identifier.uri | http://hdl.handle.net/10453/152425 | |
dc.description.abstract | <h4>Objective</h4>To identify and explore differences in spending and utilization of key health services at the end of life among hip fracture patients across seven developed countries.<h4>Data sources</h4>Individual-level claims data from the inpatient and outpatient health care sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC).<h4>Study design</h4>We retrospectively analyzed utilization and spending from acute hospital care, emergency department, outpatient primary care and specialty physician visits, and outpatient drugs. Patterns of spending and utilization were compared in the last 30, 90, and 180 days across Australia, Canada, England, Germany, New Zealand, Spain, and the United States. We employed linear regression models to measure age- and sex-specific effects within and across countries. In addition, we analyzed hospital-centricity, that is, the days spent in hospital and site of death.<h4>Data collection/extraction methods</h4>We identified patients who sustained a hip fracture in 2016 and died within 12 months from date of admission.<h4>Principal findings</h4>Resource use, costs, and the proportion of deaths in hospital showed large variability being high in England and Spain, while low in New Zealand. Days in hospital significantly decreased with increasing age in Canada, Germany, Spain, and the United States. Hospital spending near date of death was significantly lower for women in Canada, Germany, and the United States. The age gradient and the sex effect were less pronounced in utilization and spending of emergency care, outpatient care, and drugs.<h4>Conclusions</h4>Across seven countries, we find important variations in end-of-life care for patients who sustained a hip fracture, with some differences explained by sex and age. Our work sheds important insights that may help ongoing health policy discussions on equity, efficiency, and reimbursement in health care systems. | |
dc.format | Print-Electronic | |
dc.language | eng | |
dc.publisher | Wiley | |
dc.relation.ispartof | Health Services Research | |
dc.relation.isbasedon | 10.1111/1475-6773.13734 | |
dc.rights | info:eu-repo/semantics/openAccess | |
dc.subject | 1117 Public Health and Health Services, 1605 Policy and Administration | |
dc.subject.classification | Health Policy & Services | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Aged, 80 and over | |
dc.subject.mesh | Australia | |
dc.subject.mesh | Cross-Cultural Comparison | |
dc.subject.mesh | Developed Countries | |
dc.subject.mesh | Europe | |
dc.subject.mesh | Female | |
dc.subject.mesh | Health Care Costs | |
dc.subject.mesh | Hip Fractures | |
dc.subject.mesh | Hospitalization | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Insurance Claim Review | |
dc.subject.mesh | Longitudinal Studies | |
dc.subject.mesh | Male | |
dc.subject.mesh | North America | |
dc.subject.mesh | Patient Acceptance of Health Care | |
dc.subject.mesh | Retrospective Studies | |
dc.subject.mesh | Sex Factors | |
dc.subject.mesh | Terminal Care | |
dc.title | International comparison of spending and utilization at the end of life for hip fracture patients. | |
dc.type | Journal Article | |
utslib.citation.volume | 56 | |
utslib.location.activity | United States | |
utslib.for | 1117 Public Health and Health Services | |
utslib.for | 1605 Policy and Administration | |
pubs.organisational-group | /University of Technology Sydney | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health | |
pubs.organisational-group | /University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation | |
pubs.organisational-group | /University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation | |
utslib.copyright.status | open_access | * |
pubs.consider-herdc | false | |
dc.date.updated | 2021-12-20T23:15:57Z | |
pubs.issue | S3 | |
pubs.publication-status | Published | |
pubs.volume | 56 | |
utslib.citation.issue | S3 |
Abstract:
Objective
To identify and explore differences in spending and utilization of key health services at the end of life among hip fracture patients across seven developed countries.Data sources
Individual-level claims data from the inpatient and outpatient health care sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC).Study design
We retrospectively analyzed utilization and spending from acute hospital care, emergency department, outpatient primary care and specialty physician visits, and outpatient drugs. Patterns of spending and utilization were compared in the last 30, 90, and 180 days across Australia, Canada, England, Germany, New Zealand, Spain, and the United States. We employed linear regression models to measure age- and sex-specific effects within and across countries. In addition, we analyzed hospital-centricity, that is, the days spent in hospital and site of death.Data collection/extraction methods
We identified patients who sustained a hip fracture in 2016 and died within 12 months from date of admission.Principal findings
Resource use, costs, and the proportion of deaths in hospital showed large variability being high in England and Spain, while low in New Zealand. Days in hospital significantly decreased with increasing age in Canada, Germany, Spain, and the United States. Hospital spending near date of death was significantly lower for women in Canada, Germany, and the United States. The age gradient and the sex effect were less pronounced in utilization and spending of emergency care, outpatient care, and drugs.Conclusions
Across seven countries, we find important variations in end-of-life care for patients who sustained a hip fracture, with some differences explained by sex and age. Our work sheds important insights that may help ongoing health policy discussions on equity, efficiency, and reimbursement in health care systems.Please use this identifier to cite or link to this item:
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