Healthcare Costs at the End of Life for Patients with Non-cancer Diseases and Cancer in Denmark

Objectives To examine costs of care from a healthcare sector perspective within 1 year before death in patients with non-cancer diseases and patients with cancer. Methods This nationwide registry-based study identified all Danish citizens dying from major non-cancer diseases or cancer in 2010–2016. Applying the cost-of-illness method, we included costs of somatic hospitals, including hospital-based specialist palliative care, primary care, prescription medicine and hospice expressed in 2022 euros. Costs of patients with non-cancer diseases and cancer were compared using regression analyses adjusting for sex, age, comorbidity, residential region, marital/cohabitation status and income level. Results Within 1 year before death, mean total healthcare costs were €27,185 [95% confidence interval (CI) €26,970–27,401] per patient with non-cancer disease ( n = 109,723) and €51,348 (95% CI €51,098–51,597) per patient with cancer ( n = 108,889). The adjusted relative total healthcare costs, i.e. the ratio of the mean costs, of patients with non-cancer diseases was 0.64 (95% CI 0.63–0.66) at 12 months before death and 0.91 (95% CI 0.90–0.92) within 30 days before death compared with patients with cancer. Mean costs of hospital-based specialist palliative care and hospice in the year leading up to death were €17 (95% CI €13–20) and €90 (95% CI €77–102) per patient with non-cancer disease but €1552 (95% CI €1506–1598) and €3411 (95% CI €3342–3480) per patient with cancer. Conclusions Within 1 year before death, total healthcare costs, mainly driven by hospital costs, were substantially lower for patients with non-cancer diseases compared with patients with cancer. Moreover, the costs of hospital-based specialist palliative care and hospice were minimal for patients with non-cancer diseases.