Social care and hospital use at the end of life
Care of the dying can be seen as an indicator of the quality of care provided for all sick and vulnerable people. Of particular concern is the coordination of care between health and social services which is crucial for the wellbeing of many patients at this highly vulnerable stage of their lives. Yet this is also a time when efficient use of resources is important not least because the costs of care are often at their highest for individuals in the year before death. There may be scope for better use of resources that could enhance quality, in particular, by avoiding duplication of care and unnecessary high‐cost hospital care, and by offering better quality care for people at home or in the community. The national End of Life Care Strategy emphasised the importance of recognising that many people who die in hospital would prefer to die at home. Part of the reason may be that adequate support for patients and their families and carers may not be available outside hospital.
At present there are gaps in the available information on the quality, volume or cost of health care provided outside hospitals for people in the last year of life. This includes care provided by NHS primary care or community services, the voluntary sector, or social services. Such information is important when considering where care in these settings might effectively substitute, or prevent, costly hospital care. But recent advances in information and data linkage now allow some progress to be made. This report analyses for large populations, for the first time as far as we are aware, the use of NHS care and local authority‐funded social care of individuals who were in the last year of their lives. Through the use of pseudonymous record linkage, information on the use of health care and social care by people in the last months of life has been linked. The analysis is of a cohort of 16,479 people who died across three primary care trust (PCT)/local authority areas in England in 2007. The main objective of the work was to describe patterns in use of health and social care by individuals, and to identify areas for further analysis as to the quality of care that may increase the potential for appropriate substitution and greater efficiency in the use of resources.
Published : 14th November 2012
Author : Martin Bardsley, Theo Georghiou and Jennifer Dixon [ More From This Author ]
Publisher : The Nuffield Trust [ More From This Publisher ]
Rights : The Nuffield Trust
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