MEDRADSC 3DH3 Lecture Notes - Lecture 8: Stroke Recovery, Constipation, Occupational Therapist
4 Jul 2018
School
Department
Course
Professor
The Socioeconomic Impact of Palliative Care
Goal: to gain an appreciation of the financial impact of suffering when diagnosed with a life-
threatening disease
Profile of seniors in Canada
Economic Burden of Illness
People now living many years with dx of life-threatening illness
Substantial economic and human costs
o$30,000-$40,000 (e.g. CA, COPD)
Health care system covers ~70% of costs;
Affects ability to provide other government services
Patient/loved ones cover 30% of costs
Affects all domains of suffering
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Controlling or reducing cost of dying would benefit health care system, families and individuals.
oCould relieve pressure on health care resources and make it possible to re-allocate
savings to other care
The Perfect Storm
Declining income and rising expenses financial hardship
Expenses: Direct Costs
Medications- over the counter, prescriptions
Complementary therapies (integrative care)
Home health aides (wheelchairs, walkers, bathroom aides)
Home care services
oOther than those recommended by LHIN—someone comes out to assess you and they
will say how many hours they get
Modifications to home—accessibility issues
Need for long-term care setting
Can amount to more than $10,000
Health insurance plan will reduce some of these costs but not all
Expenses: Indirect Costs Costs which have a value but which money is not exchanged
Loss of employment
o29% of families affected;
e.g. $3.18 billion in wage losses due to new CA dx
oSick time/vacation time used up
oAssist loved one with medical apts, caring for conditions due to trt, emotional impact
oLoss of family savings, bankruptcy
Increased care needs
oPersonal, childcare, travel, parking costs (major concern!)
Change in family plans
o17% of families affected
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oDownsize, delay schooling plans, school absenteeism
Financial Hardship
Nearly half of Canadians will develop cancer in their lifetime. 62% are expected to survive for 5
years of more.
Nearly 1 in 5 Canadians have no private supplemental health insuranace
1 in 6 Ontario cancer patients said out-of-pocket costs were significant or unmanageable
Lost income may have a larger effect than out-of-pocket costs
Costs to Caregivers
Results in high opportunity costs
Estimate of how caregiver’s time would be valued if they provided their services within the
labour market
Impacts all domains of suffering
Caregiver burnout can be major issue
Quality of Death Index
Measures palliative care environments across 40 countries in terms of the quality and
availability of end-of-life care
Conducted by Economist’s Intelligence Unit
Criteria:
oPublic awareness
oTraining availability
oAccess to painkillers
oPhysician-patient transparency
oQuality and availability of end-of-life care
Accountability of Government
Canadians want more palliative care; divided about doctor-assisted death: survey
In a rare show of near all-party unity, the House of Commons has endorsed New Democrat MP
Charlie Angus's call for a cross-country strategy on palliative and end-of-life care. The non-
binding motion calls on the government to work with the provinces and territories to ensure
access to "high-quality, home-based and hospice palliative care," provide more support to
caregivers, and encourage Canadians to "discuss and plan for end-of-life care.“
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Goal: to gain an appreciation of the financial impact of suffering when diagnosed with a life- threatening disease. People now living many years with dx of life-threatening illness. Substantial economic and human costs: ,000-,000 (e. g. ca, copd) Health care system covers ~70% of costs; Controlling or reducing cost of dying would benefit health care system, families and individuals: could relieve pressure on health care resources and make it possible to re-allocate savings to other care. Declining income and rising expenses financial hardship. Home health aides (wheelchairs, walkers, bathroom aides) Home care services: other than those recommended by lhin someone comes out to assess you and they will say how many hours they get. Health insurance plan will reduce some of these costs but not all. Expenses: indirect costs costs which have a value but which money is not exchanged. Increased care needs: personal, childcare, travel, parking costs (major concern!)
