[A version of this item appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 2 Issue 10, May 2012].
The latest report from the National End of Life Care Intelligence Network (NEoLCIN) called “What do we know now that we didn’t know a year ago: new intelligence on end of life care in England” reminds readers that most people would prefer to die in their usual place of residence (whether home or care home), or in a hospice. Over half of these people actually die in hospital. Emergency hospital admissions do not particularly help this group of people.
The price of an inpatient admission in the last year of life ending in death is estimated to be £2,352 – £3,779; NICE estimate the cost to be £2506. The cost of an inpatient bed day ranges between £200 and £425. The cost of similar community-based end of life care is estimated to be £1,415 – £2,800. Based on typical estimated inpatient end of life care costs (£3,065.50) compared with community-based end of life care costs (£2,107.50), the potential net saving per person who dies in the community is £958. A 10% reduction in bed days for patients with a length of stay longer than eight bed days, ending in death, could save 57m in hospital costs (at £200 per bed day).
This broad ranging summary of the latest evidence concerning EoL care in England covers:
- Place of death trends.
- Inpatient hospital care in the last year of life (including statistics on dementia, cognitive impairment, delirium and depression).
- Social care in the last year of life.
- Specialist palliative care.
- Primary care in the last year of life.
- Care homes in the last year of life.
- Different disease group analyses. 60,000 deaths a year are directly attributable to dementia. 25% of deaths from Alzheimer’s Disease, dementia or senility occur in hospital.
- Costs of care.
- Unexpected / unanticipated deaths.
- Public attitudes.
- Workforce-related issues.
- Competences and training.
- Quality of care.
- Need and trends in deaths.
- Other research relating to end of life care.
National End of Life Care Intelligence Network (2012). What do we know now that we didn’t know a year ago: new intelligence on end of life care in England. London: National End of Life Care Intelligence Network (NEoLCIN), May 2012.