Temporal association between home nursing and hospital costs at end of life in three provinces

H. Seow, R. Pataky, B. Lawson, E. M. O’Leary, R. Sutradhar, K. Fassbender, K. McGrail, L. Barbera, F. Burge, S. J. Peacock, Jeffrey S Hoch

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Research has demonstrated that increases in palliative homecare nursing are associated with a reduction in the rate of subsequent hospitalizations. However, little evidence is available about the cost-savings potential of palliative nursing when accounting for both increased nursing costs and potentially reduced hospital costs. Methods Our retrospective cohort study included cancer decedents from British Columbia, Ontario, and Nova Scotia who received any palliative nursing in the last 6 months of life. A Poisson regression analysis was used to determine the association of increased nursing costs (in 2-week blocks) on the relative average hospital costs in the subsequent 2-week block and on the overall total cost (hospital costs plus nursing costs in the preceding 2-week block). Results The cohort included 58,022 cancer decedents. Results of the analysis for the last month of life showed an association between increased nursing costs and decreased relative hospital costs in comparisons with a reference group (>0 to 1 hour nursing in the block): the maximum decrease was 55% for Ontario, 31% for British Columbia, and 38% for Nova Scotia. Also, increased nursing costs in the last month were almost always associated with lower total costs in comparison with the reference. For example, cost savings per person-block ranged from $376 (>10 nursing hours) to $1,124 (>4 to 6 nursing hours) in British Columbia. Conclusions In the last month of life, increased palliative nursing costs (compared with costs for >0 to 1 hour of nursing in the block) were associated with lower relative hospital costs and a lower total cost in a subsequent block. Our research suggests a cost-savings potential associated with increased community-based palliative nursing.

Original languageEnglish (US)
Pages (from-to)S42-S51
JournalCurrent Oncology
Volume23
DOIs
StatePublished - 2016
Externally publishedYes

Fingerprint

Home Nursing
Hospital Costs
Hospice and Palliative Care Nursing
Nursing
Costs and Cost Analysis
British Columbia
Cost Savings
Nova Scotia
Ontario
Research
Neoplasms
Hospitalization
Cohort Studies
Retrospective Studies

Keywords

  • Canadian data
  • Costing
  • End of life
  • Homecare
  • Hospitalization
  • Nursing
  • Palliative care

ASJC Scopus subject areas

  • Oncology

Cite this

Temporal association between home nursing and hospital costs at end of life in three provinces. / Seow, H.; Pataky, R.; Lawson, B.; O’Leary, E. M.; Sutradhar, R.; Fassbender, K.; McGrail, K.; Barbera, L.; Burge, F.; Peacock, S. J.; Hoch, Jeffrey S.

In: Current Oncology, Vol. 23, 2016, p. S42-S51.

Research output: Contribution to journalArticle

Seow, H, Pataky, R, Lawson, B, O’Leary, EM, Sutradhar, R, Fassbender, K, McGrail, K, Barbera, L, Burge, F, Peacock, SJ & Hoch, JS 2016, 'Temporal association between home nursing and hospital costs at end of life in three provinces', Current Oncology, vol. 23, pp. S42-S51. https://doi.org/10.3747/co.23.2971
Seow H, Pataky R, Lawson B, O’Leary EM, Sutradhar R, Fassbender K et al. Temporal association between home nursing and hospital costs at end of life in three provinces. Current Oncology. 2016;23:S42-S51. https://doi.org/10.3747/co.23.2971
Seow, H. ; Pataky, R. ; Lawson, B. ; O’Leary, E. M. ; Sutradhar, R. ; Fassbender, K. ; McGrail, K. ; Barbera, L. ; Burge, F. ; Peacock, S. J. ; Hoch, Jeffrey S. / Temporal association between home nursing and hospital costs at end of life in three provinces. In: Current Oncology. 2016 ; Vol. 23. pp. S42-S51.
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abstract = "Background Research has demonstrated that increases in palliative homecare nursing are associated with a reduction in the rate of subsequent hospitalizations. However, little evidence is available about the cost-savings potential of palliative nursing when accounting for both increased nursing costs and potentially reduced hospital costs. Methods Our retrospective cohort study included cancer decedents from British Columbia, Ontario, and Nova Scotia who received any palliative nursing in the last 6 months of life. A Poisson regression analysis was used to determine the association of increased nursing costs (in 2-week blocks) on the relative average hospital costs in the subsequent 2-week block and on the overall total cost (hospital costs plus nursing costs in the preceding 2-week block). Results The cohort included 58,022 cancer decedents. Results of the analysis for the last month of life showed an association between increased nursing costs and decreased relative hospital costs in comparisons with a reference group (>0 to 1 hour nursing in the block): the maximum decrease was 55{\%} for Ontario, 31{\%} for British Columbia, and 38{\%} for Nova Scotia. Also, increased nursing costs in the last month were almost always associated with lower total costs in comparison with the reference. For example, cost savings per person-block ranged from $376 (>10 nursing hours) to $1,124 (>4 to 6 nursing hours) in British Columbia. Conclusions In the last month of life, increased palliative nursing costs (compared with costs for >0 to 1 hour of nursing in the block) were associated with lower relative hospital costs and a lower total cost in a subsequent block. Our research suggests a cost-savings potential associated with increased community-based palliative nursing.",
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