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Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
versión impresa ISSN 2225-5109versión On-line ISSN 2227-4731
Resumen
AMADO-TINEO, José et al. Analysis of health care costs for patients with cancer at the end of life: Hospital versus home with palliative care, at the third level of care. Rev. Cuerpo Med. HNAAA [online]. 2022, vol.15, n.2, pp.174-179. Epub 10-Jun-2022. ISSN 2225-5109. http://dx.doi.org/10.35434/rcmhnaaa.2022.152.1071.
Background:
The final stage of cancer patients generates high costs, especially in hospitals. Objectives: To determine the difference in care costs at the end of life for cancer patients in the hospital versus at home.
Material and methods:
Retrospective cost analysis study in patients who died of clinical stage IV cancer in a tertiary social security hospital, March 2018. A home group (Home) of a palliative program was compared with a hospital group (Hospital) admitted from the emergency department. Direct costs of professional services, hospitalization, procedures, auxiliary exams, and medications were estimated. Chi square and Student's T were used for statistical analysis, considering a value of p<0.05 and using SPSS 24.0.
Results:
81 patients in Home and 22 in Hospital were included, aged between 36 and 96 years, with a median of 72 years in Home and 77 in Hospital (p=0.97), female sex 59 and 73% respectively (p= 0.25), predominantly cancer of digestive and genitourinary origin. The average cost per patient in Home was 497 US dollars and in Hospital 1908 (p<0.01), with a daily average per patient of 17 vs 447 respectively. In the Hospital, the costs of hospitalization, auxiliary tests (tomography, resonance, arterial gas analysis, C-reactive protein) and antibiotics (ertapenem and colistin) predominated, while in the Home the highest cost was in medical services and medications.
Conclusion:
The medical costs in the final stage of life of patients with advanced cancer are 3.8 times higher when they die in the hospital than at home
Palabras clave : Costs and cost analysis; medical care; terminal stage of illness: death.