Abstract：
:A significant proportion of health care resources are consumed at end of life. As a result, decision and policy makers seek cost savings to enhance program planning. Most literature, however, combines the cost of all dying patients and, subsequently, fails to recognize the variation between trajectories of functional decline and utilization of health care services. In this article, we classified dying Albertans by categories of functional decline and assessed their utilization and costs. We used data from two years of health care utilization and costs for three annual cohorts of permanent residents of Alberta, Canada (April 1999 to March 2002). Literature, expert opinion, and cluster analysis were used to categorize the deceased according to sudden death, terminal illness, organ failure, frailty, and other causes of death. Expenditures were decomposed into constituent quantities and prices. We found that nearly 18,000 die per year in Alberta: sudden death (7.1%), terminal illness (29.8%), organ failure (30.5%), frailty (30.2%), and other causes (2.3%). Inpatient care remains the primary cost driver for all trajectories. Significant and predictable health care services are required by noncancer patients. Trajectories of costs are significantly different for the four categories of dying Albertans. Trajectories of dying are a useful classification for analyzing health care use and costs.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Fassbender K,Fainsinger RL,Carson M,Finegan BAdoi
10.1016/j.jpainsymman.2009.04.007subject
Has Abstractpub_date
2009-07-01 00:00:00pages
75-80issue
1eissn
0885-3924issn
1873-6513pii
S0885-3924(09)00502-8journal_volume
38pub_type
杂志文章abstract：:The aim of this study was to examine the relationship of changes in hemoglobin levels to changes in fatigue and cognitive functioning in cancer patients undergoing chemotherapy treatment. Seventy-seven (77) patients completed a self-administered measure of fatigue and a battery of psychometrician-administered measures...
journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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