Till death do us part: the effect of marital status on health care utilization and costs at end-of-life. A register study on all colorectal cancer decedents in Norway between 2009 and 2013

Bjørnelv, Gudrun Maria Waaler; Edwin, Bjørn; Deb, Partha; Aas, Eline

doi:10.1186/s12913-019-4794-6

Cited by 18 publications

(23 citation statements)

References 43 publications

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“…Marital status, coping with the diagnosis, dealing with pain, and a reduced willingness among men to seek healthcare might all play a part 21 . Similar findings have been reported in colorectal cancer, where a recent Scandinavian study 22 noted that married patients spent 30 days less in hospital, and used less home- and community-based care in an end-of-life setting. A study from 2019 found that married patients with advanced cancer were less likely to have potentially avoidable readmissions 23 .…”

Section: Discussionsupporting

confidence: 83%

Burden of in-hospital care in oesophageal cancer: national population-based study

et al. 2021

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Background Oesophageal cancer management requires extensive in-hospital care. This cohort study aimed to quantify in-hospital care for patients with oesophageal cancer in relation to intended treatment, and to analyse factors associated with risk of spending a large proportion of survival time in hospital. Methods All patients with oesophageal cancer in three nationwide registers over a 10-year period were included. In-hospital care during the first year after diagnosis was evaluated, and the proportion of survival time spent in hospital, stratified by intended treatment (curative, palliative or best supportive care), was calculated. Associations between relevant factors and a greater proportion of survival time in hospital were analysed by multivariable logistic regression. Results In-hospital care was provided for a median of 39, 26, and 15 days in the first year after diagnosis of oesophageal cancer in curative, palliative, and best supportive care groups respectively. Patients receiving curatively intended treatment spent a median of 12 per cent of their survival time in hospital during the first year after diagnosis, whereas those receiving palliative or best supportive care spent 19 and 23 per cent respectively. Factors associated with more in-hospital care included older age, female sex, being unmarried, and chronic obstructive pulmonary disease. Conclusion The burden of in-hospital care during the first year after diagnosis of oesophageal cancer was substantial. Important clinical and socioeconomic factors were identified that predisposed to a greater proportion of survival time spent in hospital.

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Section: Discussionsupporting

confidence: 83%

Burden of in-hospital care in oesophageal cancer: national population-based study

et al. 2021

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“…The study population is further divided into the married and widowed group. Moreover, as the sex aspect having a material impact on the health service utilisation, this study further used men and women elderly separately by their marital Status [5,22]…”

Section: Study Samplementioning

confidence: 99%

“…The marital status and its association with health status has been at the forefront of investigation for a long time but with insu cient explanations. Previous studies have demonstrated that with the change in marital status, individuals experience differential health status and health care utilisation [1][2][3][4][5]. Studies have reported that nonmarried individuals are perhaps more deprived in terms of social and economic status compared to their counterparts, married individuals [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Studies have reported that nonmarried individuals are perhaps more deprived in terms of social and economic status compared to their counterparts, married individuals [6][7][8]. However, even after adjusting for different socioeconomic and demographic factors, studies have found that non-married especially the widowed suffer more ill-health and depend more on the health care services [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…The consequences of the widowhood ultimately re ect in the health outcome and dependency on health services. Studies have found that older widowed females are more dependent on health care use than widowed males [5,22]. Davidson and others (2011) argue that despite female widows seeks more health care services, very little of the health services professionally meet as per the needs of widows compare to male widows [18].…”

Section: Introductionmentioning

confidence: 99%

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Marital Status, Sex and Utilisation of Healthcare Service Among the Older Adults in India

Hossain¹,

James²,

Rana³

2020

Preprint

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Background: The association between marital status and health status among the elderly has been at the forefront of investigation for a long time. However, the study on the effects of marital status on health care utilisation is limited. This study assesses the association between use of inpatient health services and marital status among older adults in India from the perspective of sex. Methods: Data used in the study have been obtained from the 75th Round of National Sample Survey (NSS) on "Social Consumption: Health" with the sample size of 42,762 individuals aged 60 years or above. The study implements the Andersen's behavioural framework controlling the predisposing, enabling, and need characteristics and uses binary logistic regression models to assess the effect of marital status on inpatient health service. Results: There is a significant difference in inpatient healthcare use between married and widowed elderly by age, educational level, perceived health and mobility for both sexes. The unadjusted regression analysis shows that widowed are more likely to use inpatient health services both for women (OR=1.57; CI 95%= 1.47, 1.68) and men (OR=1.11; CI 95%= 1.02, 1.2). However, after controlling the predisposing, enabling, and need factors, a strong association between healthcare services and marital status has been found for women, but not for men. Widowed women (OR=1.43; CI 95%=1.33, 1.54) are more likely to use inpatient health care than married women. Conclusion: The present study has reported the association between the utilisation of inpatient health services and marital status for the elderly in India. Our study advocates that there is a sex difference in the utilisation of inpatient health services by the marital Status in India. Older widowed women should get more focus on health and elderly policy perspectives.

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The costs of chronic pain—Long‐term estimates

Stubhaug,

Hansen,

Hallberg

et al. 2024

European Journal of Pain

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BackgroundChronic pain is a condition with severe impact on many aspects of life, including work, functional ability and quality of life, thereby reducing physical, mental and social well‐being. Despite the high prevalence and burden of chronic pain, it has received disproportionally little attention in research and public policy and the societal costs of chronic pain remain largely unknown. This study aimed to describe the long‐term healthcare and work absence costs of individuals with and without self‐identified chronic pain.MethodsThe study population were participants in two Norwegian population health studies (HUNT3 and Tromsø6). Participants were defined as having chronic pain based on a self‐reported answer to a question on chronic pain in the health studies in 2008. Individuals in the study population were linked to four national register databases on healthcare resource use and work absence.ResultsIn our study, 36% (n = 63,782) self‐reported to have chronic pain and the average years of age was 56.6. The accumulated difference in costs between those with and without chronic pain from 2010 to 2016 was €55,003 (CI: 54,414–55,592) per individual. Extrapolating this to the entire population suggests that chronic pain imposes a yearly burden of 4% of GDP. Eighty per cent of the costs were estimated to be productivity loss.ConclusionInsights from this study can provide a greater understanding of the extent of healthcare use and productivity loss by those with chronic pain and serve as an important basis for improvements in rehabilitation and quality of care, and the education of the public on the burden of chronic pain.SignificanceThis was the first study to estimate the economic burden associated with chronic pain in the general population using linked individual‐level administrative data and self‐reported survey answers. We provide calculations showing that annual costs of chronic pain may be as high as €12 billion or 4% of GDP. Findings from this study highlight the need for a greater understanding of the substantial healthcare use and productivity losses among individuals with chronic pain.

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Till death do us part: the effect of marital status on health care utilization and costs at end-of-life. A register study on all colorectal cancer decedents in Norway between 2009 and 2013

Cited by 18 publications

References 43 publications

Burden of in-hospital care in oesophageal cancer: national population-based study

Burden of in-hospital care in oesophageal cancer: national population-based study

Marital Status, Sex and Utilisation of Healthcare Service Among the Older Adults in India

The costs of chronic pain—Long‐term estimates

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