About 40,000 people die in Norway every year. About 80 percent of those are over 70 years old, and 60 percent are over 80 years old when they die. In general, the use of health services increases in the last years of life. In the context of changes in age structure over the next decades, with increasing numbers of elderly, this implies challenges for the health services. Knowledge of the consumption of health care in the last years of life, and associated costs, is therefore highly relevant for service providers, health professionals and health authorities, regarding capacity and design of future health care.
Greater emphasis on decentralised services is seen both internationally and in Norway, and this is one of the main goals of the Coordination Reform. To facilitate good services at the end of life is an important part of this. The trend in recent years has been an increasing proportion of people die outside hospitals. What factors contributes to this trend? Are there significant differences in use of services in the last years of life for those who die in hospitals and elsewhere? Are differences in health care consumptions in the last years of life primarily related to the characteristics of the patients, or can observed differences be explained by differences in demand and supply conditions in the health care services? Is care in the final stages of life outside the hospital in keeping with patients' wishes and are the municipalities equipped to provide high quality services? Will shift in responsibilities and tasks from hospital to municipalities help to reduce the overall costs of health care related to the last years of life? A good knowledge base is essential to answer those questions.
The project will contribute to this knowledge through quantitative analyses of data from national health registers, and through qualitative analyses based on data collected through interviews with family members and health care providers in three municipalities, and survey among health professionals in a community sample of municipalities.
The project is funded by the Norwegian Research Council.
- Avd. for sykepleierutdanning, College of Sør-Trøndelag (HIST) (https://hist.no/asp/)
- Dept. of Public Health and General Practice, Norwegian University of Science and Technology (NTNU) (http://www.ntnu.no/ism)
- COCTEL-research group at the Tampere School of Public Health, University of Tampere, Finland http://www.uta.fi/hes/en/research/Research_groups/HealthEconomics/coctel.html)