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Costs and advance directives at the end of life: a case of the ‘Coaching Older Adults and Carers to have their preferences Heard (COACH)’ trial

Kaambwa, Billingsley, Ratcliffe, Julie, Bradley, Sandra L., Masters, Stacey, Davies, Owen, Whitehead, Craig, Milte, Catherine, Cameron, Ian D., Young, Tracey, Gordon, Jason and Crotty, Maria 2015, Costs and advance directives at the end of life: a case of the ‘Coaching Older Adults and Carers to have their preferences Heard (COACH)’ trial, BMC health services research, vol. 15, Article Number : 545, pp. 1-12, doi: 10.1186/s12913-015-1201-9.

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Title Costs and advance directives at the end of life: a case of the ‘Coaching Older Adults and Carers to have their preferences Heard (COACH)’ trial
Author(s) Kaambwa, Billingsley
Ratcliffe, Julie
Bradley, Sandra L.
Masters, Stacey
Davies, Owen
Whitehead, Craig
Milte, CatherineORCID iD for Milte, Catherine orcid.org/0000-0003-0035-6405
Cameron, Ian D.
Young, Tracey
Gordon, Jason
Crotty, Maria
Journal name BMC health services research
Volume number 15
Season Article Number : 545
Start page 1
End page 12
Total pages 12
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2015
ISSN 1472-6963
Keyword(s) End of life
Advance directives
Care plans
Costs
Summary BACKGROUND: Total costs associated with care for older people nearing the end of life and the cost variations related with end of life care decisions are not well documented in the literature. Healthcare utilisation and associated health care costs for a group of older Australians who entered Transition Care following an acute hospital admission were calculated. Costs were differentiated according to a number of health care decisions and outcomes including advance directives (ADs).

METHODS: Study participants were drawn from the Coaching Older Adults and Carers to have their preferences Heard (COACH) trial funded by the Australian National Health and Medical Research Council. Data collected included total health care costs, the type of (and when) ADs were completed and the place of death. Two-step endogenous treatment-regression models were employed to test the relationship between costs and a number of variables including completion of ADs.

RESULTS: The trial recruited 230 older adults with mean age 84 years. At the end of the trial, 53 had died and 80 had completed ADs. Total healthcare costs were higher for younger participants and those who had died. No statistically significant association was found between costs and completion of ADs.

CONCLUSION: For our frail study population, the completion of ADs did not have an effect on health care utilisation and costs. Further research is needed to substantiate these findings in larger and more diverse clinical cohorts of older people.
Language eng
DOI 10.1186/s12913-015-1201-9
Field of Research 1117 Public Health And Health Services
0807 Library And Information Studies
Socio Economic Objective 920211 Palliative Care
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080451

Document type: Journal Article
Collections: School of Exercise and Nutrition Sciences
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.