Using linked health use data and council data to examine health and social care use at the end of life

Health care costs tend to rise sharply as individuals approach the end of life. Patients prefer dying at home rather than hospital, however, half of deaths in England occur in hospitals and little is known about related costs across health and social care sectors.  

We explored how end-of-life costs vary depending on where you die, receipt of hospice care, and the disease you die from, and health service use and costs for end-of-life patients across multiple care sectors e.g. primary, hospital, community, social care, focusing on how patients’ preferences of place of death can be addressed.

We found that trajectories of end-of-life healthcare costs vary by place of death in a differential way across health and social care sectors.

Findings show those who died in hospital were associated with higher hospital and mental health care costs, but lower social care costs.

These findings will inform care model design, e.g. Advance Care Planning for end-of-life patients’ conversations with medical teams to plan future support and care, aligning patients’ preferences and policymakers’ objectives to maximise resource allocation.

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UCL Institute of Health Equity