Case-control study of end-of-life treatment preferences and costs following advance care planning for adults with end-stage kidney disease.
Nephrology (Carlton)
; 24(2): 148-154, 2019 Feb.
Article
en En
| MEDLINE
| ID: mdl-29389053
ABSTRACT
AIM:
The aim of the present study was to examine the efficacy of advance care planning (ACP) to improve the likelihood that end-stage kidney disease (ESKD) patient's preferences will be known and adhered to at end-of-life.METHODS:
A case-control study of a nurse-led ACP programme in adults with ESKD from a major tertiary hospital. The primary outcome was the proportion of patients whose preferences were known (by substitute decision maker and/or clinicians) and adhered to by their treating doctors. Secondary measures were health system resource use and costs ($AUD) for a nurse-led ACP intervention in the last 12-months of life.RESULTS:
In total, 57 cases (38 men, mean age 73.8 years) and 57 historical controls (38 men, mean age 74.0 years) were included. Cases (38/57, 67%) were significantly more likely than controls (15/57, 26%) to have their preferences known and adhered to by their treating doctor at end-of-life (P < 0.001). Cases (33/40, 83%) were also significantly more likely to withdraw from dialysis in accordance with their preferences than controls (11/33, 33%) (P < 0.001). For cases, the average hospital costs in the last 12 months of life was AUD $99 077 (SD = $71 002) per patient. The total cost of the ACP programme in 2010/2011 was AUD $26 821.CONCLUSION:
Advance care planning was associated with improvements in end-of-life care preferences being known and adhered to for people with ESKD.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Evaluación de Procesos y Resultados en Atención de Salud
/
Cuidado Terminal
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Costos de Hospital
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Planificación Anticipada de Atención
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Prioridad del Paciente
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Fallo Renal Crónico
Tipo de estudio:
Diagnostic_studies
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Health_economic_evaluation
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Nephrology (Carlton)
Asunto de la revista:
NEFROLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Australia