Novel research to improve care at the end of life
Economic evaluation supplies information about the costs and benefits of different interventions for end-of-life care (EoLC). However, existing frameworks for assessing EoLC are insufficient because they focus exclusively on health and the patient. What is more, they do not address several key issues, including defining the end-of-life phase and measuring the consequence of EoLC. With this in mind, the EU-funded ECONENDLIFE (The economic evaluation of end of life care) project set out to develop measures for the economic evaluation of EoLC. Project partners proposed two measures to assess the opportunity for receiving supportive care and a dignified death. The ICECAP Supportive Care Measure (ICECAP-SCM) focused on the individual at the end of life and the ICECAP Close Person Measure (ICECAP-CPM) on family and friends. The ECONENDLIFE team assessed the validity of the ICECAP-SCM, a self-complete questionnaire developed as a tool for use in economic evaluation carried out in an end-of-life setting. Researchers analysed the responses and reaction of volunteer patients and their close persons to the questionnaire. ICECAP-SCM covers the seven most important aspects of EoLC: choice; love and affection; physical suffering; emotional suffering; dignity; being supported; and preparation. The levels for each factor are expressed in terms of capabilities. To devise the ICECAP-CPM, project members interviewed subjects who are close to a person at the end of life or are recently bereaved. They identified six factors that are important to the friends and family of a dying patient: communication; practical support; privacy and space; emotional support; preparing and coping; and emotional distress. Thanks to ECONENDLIFE, economists are more equipped to assess the benefits of EoLC that are meaningful and important. This will help to better inform key actors and policymakers.
Keywords
Economic evaluation, end-of-life care, ECONENDLIFE, ICECAP Supportive Care Measure, ICECAP Close Person Measure
