Análisis del esfuerzo terapéutico y el coste económico que se producen en la actividad asistencial a un grupo de pacientes ingresados en proceso de final de vida

Abstract

Aim

There are social inequalities in access to health care that affect therapeutic effort. The aim of the present study was to determine whether there are differences in expenditure according to days of admission and tests performed by age, sex and population of origin in patients at the end of life.

Methods

Cross-sectional descriptive study, with review of clinical histories of terminally ill patients admitted to a hospital, recruited on the basis of the administration of transfusions, who underwent numerous tests and interventions during their last admission before death. Sociodemographic and clinical variables were studied, as well as the cost of admission and tests.

Results

The 140 patients were hospitalized for an average of 17.41 days (SD: 14.323), with an average cost of €8,264.19 (SD: 6,799.8788) per stay. They underwent 59 tests, which amounted to €532,209.68. Being male, of advanced age and of rural origin saw an increase in the number of days of admission. Older people and women received more tests. No relationship was found between days of hospitalization and expenditure with sociodemographic and clinical variables. There was a relationship between surgical interventions and sex (p = 0.047); between age and receiving oncological treatments (p < 0), other techniques (p < 0), nuclear medicine tests (p = 0.02) and electrocardiograms (p = 0.052).

Conclusions

Many palliative patients die in hospitals receiving numerous tests that increase the number of days of hospitalization and costs. Advanced age determines hospital admissions, but not sex or population of origin.