Financial hardship and the intensity of medical care received near death. Academic Article Article uri icon

Overview

MeSH

  • Aged
  • Cohort Studies
  • Cost of Illness
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies
  • Socioeconomic Factors

MeSH Major

  • Caregivers
  • Critical Care
  • Economics
  • Neoplasms
  • Patient Preference
  • Terminal Care

abstract

  • Although end-of-life (EOL) care can present a substantial financial burden for the household, the influence of this burden on the intensity of care received at the EOL remains unknown. The goal of this study was to determine the association between financial hardship and intensive care in the last week of life. The Coping with Cancer (CwC) Study is a longitudinal, multisite cohort study of terminally ill cancer patients and their informal caregivers, September 2002-February 2008. Patients (N = 281) were followed from baseline to death, a median of 4.4 months after baseline assessment. Intensive care was defined as the use of resuscitation and/or ventilation in the patient's last week of life. Financial hardship was measured at study baseline as a positive response to whether the household had to use all or most of their savings because of the family member's illness. Twenty-nine percent reported financial hardship, and 9% received intensive EOL care. Patients reporting financial hardship had a 3.22 (95% CI: 1.38, 7.53) higher likelihood of receiving intensive EOL care compared with patients not reporting financial hardship. After adjusting for sociodemographic characteristics and patient preferences, patients reporting financial hardship had a 3.05 (95% CI: 1.22, 7.62) higher likelihood of receiving intensive EOL care. The depletion of a family's financial resources is a significant predictor of intensive EOL care, over and above the influence of sociodemographic characteristics and patient preferences. Copyright © 2014 John Wiley & Sons, Ltd.

publication date

  • May 2015

has subject area

  • Aged
  • Caregivers
  • Cohort Studies
  • Cost of Illness
  • Critical Care
  • Economics
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neoplasms
  • Patient Preference
  • Prospective Studies
  • Socioeconomic Factors
  • Terminal Care

Research

keywords

  • Journal Article
  • Multicenter Study

Identity

Language

  • eng

PubMed Central ID

  • PMC4305037

Digital Object Identifier (DOI)

  • 10.1002/pon.3624

PubMed ID

  • 25052138

Additional Document Info

start page

  • 572

end page

  • 578

volume

  • 24

number

  • 5