During the COVID-19 pandemic there was a period of high excess deaths for common causes such as cancer, with especially high excess cancer deaths happening at home as opposed to in hospital or in care homes. In this paper we aim to explore whether healthcare utilisation trajectories of cancer patients in the final months of life during the COVID-19 pandemic reveal any potential unmet healthcare need. We use English hospital records linked to data on all deaths in and out of hospital which identifies the cause and location of death.
Our analysis shows that during the periods of peak COVID-19 caseload patients dying of cancer experienced up to 43% less hospital treatment in their final month of life compared to historical controls. We find reductions in end-of-life hospital care for cancer patients dying in hospitals, care homes/hospices and at home, however the effect is amplified by the shift to more patients dying at home. Through the first year of the pandemic in England, we estimate the number of inpatient bed-days for end-of-life cancer patients in their final month reduced by approximately 287,046, or 26%.
For outpatient appointments in the final month of life we find a reduction in face-to-face appointments and an increase in remote appointments which persists through the pandemic year and is not confined only to the periods of peak COVID-19 caseload.
Speaker: Peter Sivey; Centre for Health Economics, York.
Peter Sivey is a Reader (Associate Professor) in Health Economics at the Centre for Health Economics, University of York and previously worked at RMIT University, La Trobe University, and University of Melbourne in Melbourne, Australia.
His research interests centre on the economics of healthcare markets. He is working on research projects including hospital waiting times, emergency department performance, competition in health care and doctors' labour markets. He has a PhD in Economics (2009) from the University of York and is an Associate Editor of Health Economics.
Link zoom: https://unibocconi-it.zoom.us/j/95490005607?pwd=dkxnaVdaaUFQTy9QbXBHdjY5Z3Z4dz09
Meeting ID: 954 9000 5607
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