Regional differences in medical care at the end of life

Studies in many countries have shown that the extent of medical treatments in the last phase of life can vary considerably across regions. The different patterns of medical care not only reflect the effective needs of patients and their families but are also associated with different structure of supply - that is, different regional availability of hospitals, physicians, and nursing homes. This suggests that there may be inadequate provision of medical care to patients who are in a particularly sensitive phase of life.

This study aims to document the regional variation of medical treatments at the end of life in Switzerland and to identify possible causes of different patterns of medical care. Hospitals service areas will be used as geographical units. This will allow a population-based documentation of regionally available resources (number of hospitals, medical professionals, medical equipment, etc., per 1 000 residents) and their utilisation, independent of administrative or other predefined boundaries. Using data from the health insurance companies, the study will trace the patients’ treatment paths for outpatient services, and care in hospitals, old peoples homes and nursing homes in the last 12 months of their lives. Regional differences in treatment intensity and the associated costs of individual patients will be determined and examined in connection with the regionally available medical services.

The results will support an efficient and equitable access to the best available care for a population during the last twelve months of life.

Regional and temporal variation in end of life care in Switzerland