Background

Cancer patients have one of the highest health care expenditures (HCE) at the end of life. However, the growth of HCE at the end of life remains poorly documented in the literature.

Objective

To describe monthly reimbursed expenditure during the last year of life among cancer patients, by performing detailed analysis according to type of expenditure and the person’s age.

Method

Data were derived from the Système national des données en santé (SNDS) [national health data system], which comprises information on ambulatory and hospital care. Analyses focused on general scheme beneficiaries (77% of the French population) treated for cancer who died in 2015.

Results

Average reimbursed expenditure during the last year of life was €34,300 per person in 2015, including €21,100 (62%) for hospital expenditure. "Short-stays hospital" and "rehabilitation units" stays expenditure were €14,700 and €2000, respectively. Monthly expenditure increased regularly towards the end of life, increasing from 12 months before death €2000 to €5200 1 month before death. The highest levels of expenditure did not concern the oldest people, as average reimbursed expenditure was €50,300 for people 18–59 years versus €25,600 for people 80–90 years. Out-of-pocket payments varied only slightly according to age, but increased towards the end of life.

Conclusion

A marked growth of HCE was observed during the last 4 months of life, mainly driven by hospital expenditure, with a more marked growth for younger people.

中文翻译：

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2015 年癌症患者死亡前一年医疗保健利用率和支出的变化：法国基于 snds 的队列研究

 背景

癌症患者是临终时医疗保健支出 (HCE) 最高的患者之一。然而，文献中对临终 HCE 增长的记录仍然很少。

 客观的

通过根据支出类型和患者年龄进行详细分析，描述癌症患者生命最后一年的每月报销支出。

 方法

数据来自国家卫生数据系统(SNDS)，其中包括门诊和医院护理信息。分析重点关注 2015 年因癌症治疗而去世的一般计划受益人（占法国人口的 77%）。

 结果

2015 年，每人生命最后一年的平均报销支出为 34,300 欧元，其中包括 21,100 欧元（62%）的医院支出。 “短期住院”和“康复中心”住院支出分别为 14,700 欧元和 2000 欧元。临终前每月支出定期增加，从死亡前 12 个月的 2000 欧元增加到死亡前 1 个月的 5200 欧元。最高水平的支出并不涉及最年长的人，因为 18-59 岁人群的平均报销支出为 50,300 欧元，而 80-90 岁人群的平均报销支出为 25,600 欧元。自付费用随年龄的不同而略有不同，但随着年龄的增长而增加。

 结论

在生命的最后 4 个月，HCE 显着增长，主要是由医院支出驱动，其中年轻人的增长更为显着。