Husted, Marie Gade3; Kriegbaum, Margit5; Kirkegaard, Nicolai4; Lange, Peter6
1 Section of Health Services Research, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet2 Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet3 Danish Lung Association, Copenhagen, Denmark.4 unknown5 Section of Health Services Research, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet6 Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet
A retrospective nationwide study
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 COPD and LC might indicate a substantial need for palliative care in these patients.
B M J Supportive and Palliative Care, 2014, Vol 4, Issue 2, p. 146-151