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Variability in end-of-life healthcare use in patients with osteoarthritis : a population-based matched cohort study

Kiadaliri, Ali LU orcid and Englund, Martin LU orcid (2021) In Osteoarthritis and Cartilage 29(10). p.1418-1425
Abstract

PURPOSE: To investigate the patterns of healthcare use (HCU) at the last year of life in persons with osteoarthritis (OA).

METHODS: Using linked registers, we identified persons aged≥ 65 years who died during 2003-2014 and were resided in the Skåne region during 5-year prior to death. Among these, we randomly matched decedents with a principal OA diagnosis prior to the last year of life (OA cohort, n=17,993) with up to 4 comparators without OA by sex, age at death, and year of death (n=59,945). We measured monthly HCU for each decedent during last year of life and applied two-part regression models to estimate HCU attributable to OA. Group-based trajectory modelling (GBTM) was used to detect distinct trajectories of HCU within the... (More)

PURPOSE: To investigate the patterns of healthcare use (HCU) at the last year of life in persons with osteoarthritis (OA).

METHODS: Using linked registers, we identified persons aged≥ 65 years who died during 2003-2014 and were resided in the Skåne region during 5-year prior to death. Among these, we randomly matched decedents with a principal OA diagnosis prior to the last year of life (OA cohort, n=17,993) with up to 4 comparators without OA by sex, age at death, and year of death (n=59,945). We measured monthly HCU for each decedent during last year of life and applied two-part regression models to estimate HCU attributable to OA. Group-based trajectory modelling (GBTM) was used to detect distinct trajectories of HCU within the OA cohort.

RESULTS: During last 12-month of life, each person with OA had, on average, 2.5 (95% CI 2.2, 2.7) excess healthcare consultations and 1.8 (95% CI 1.3, 2.2) more inpatient days than those without OA. While both cohorts observed increasing trends in HCU towards death, excess healthcare consultations attributable to OA declined and inpatient days increased as death approached. For both healthcare consultations and inpatient days, GBTM identified four distinct trajectory classes. While underlying cause of death and age were the most important predictors of class membership, the overall predictive accuracy was poor.

CONCLUSION: OA was associated with excess HCU especially hospital-based care during the last year of life. However, there seem to be distinct trajectory classes within the OA patient population.

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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Osteoarthritis and Cartilage
volume
29
issue
10
pages
1418 - 1425
publisher
W.B. Saunders
external identifiers
  • pmid:34273532
  • scopus:85111886568
ISSN
1063-4584
DOI
10.1016/j.joca.2021.07.001
language
English
LU publication?
yes
id
d4f59b8f-47cd-404a-b05a-6b90d6a21ed3
date added to LUP
2021-07-21 14:21:41
date last changed
2025-06-15 23:07:44
@article{d4f59b8f-47cd-404a-b05a-6b90d6a21ed3,
  abstract     = {{<p>PURPOSE: To investigate the patterns of healthcare use (HCU) at the last year of life in persons with osteoarthritis (OA).</p><p>METHODS: Using linked registers, we identified persons aged≥ 65 years who died during 2003-2014 and were resided in the Skåne region during 5-year prior to death. Among these, we randomly matched decedents with a principal OA diagnosis prior to the last year of life (OA cohort, n=17,993) with up to 4 comparators without OA by sex, age at death, and year of death (n=59,945). We measured monthly HCU for each decedent during last year of life and applied two-part regression models to estimate HCU attributable to OA. Group-based trajectory modelling (GBTM) was used to detect distinct trajectories of HCU within the OA cohort.</p><p>RESULTS: During last 12-month of life, each person with OA had, on average, 2.5 (95% CI 2.2, 2.7) excess healthcare consultations and 1.8 (95% CI 1.3, 2.2) more inpatient days than those without OA. While both cohorts observed increasing trends in HCU towards death, excess healthcare consultations attributable to OA declined and inpatient days increased as death approached. For both healthcare consultations and inpatient days, GBTM identified four distinct trajectory classes. While underlying cause of death and age were the most important predictors of class membership, the overall predictive accuracy was poor.</p><p>CONCLUSION: OA was associated with excess HCU especially hospital-based care during the last year of life. However, there seem to be distinct trajectory classes within the OA patient population.</p>}},
  author       = {{Kiadaliri, Ali and Englund, Martin}},
  issn         = {{1063-4584}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{10}},
  pages        = {{1418--1425}},
  publisher    = {{W.B. Saunders}},
  series       = {{Osteoarthritis and Cartilage}},
  title        = {{Variability in end-of-life healthcare use in patients with osteoarthritis : a population-based matched cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.joca.2021.07.001}},
  doi          = {{10.1016/j.joca.2021.07.001}},
  volume       = {{29}},
  year         = {{2021}},
}