Demographic characteristics of all deaths with cancer as the underlying cause of death in England, 1993–2010.

a<p>The region was defined by Strategic Health Authorities (SHAs) (July 2006).</p

Proportion ratios and 95% CIs of variables associated with place of death (home/hospice versus hospital) in England 1993–2010.

<p>PRs were estimated from the log-binomial regression models. The clustering effect within the LSOA geographical units was adjusted using the general estimating equation (GEE) method. In additional to variables listed in the table, models were also adjusted for the calendar year of death. A PR greater than 1 indicates higher probability of death at home/hospice than the reference category. The <i>p</i>-value for overall association of individual factors with PoD was smaller than 0.001 in all models.</p

ICD-9 and ICD-10 codes used for the classification of underlying cause of death as cancers.

<p>ICD-9 and ICD-10 codes used for the classification of underlying cause of death as cancers.</p

Place of cancer deaths in England, 1993–2010, age- and gender-standardised against the UN mortality standard population [<b>24</b>].

<p>The 95% CIs were not plotted as they were too narrow to show.</p

Additional file 1: Table S1. of Measuring geographical accessibility to palliative and end of life (PEoLC) related facilities: a comparative study in an area with well-developed specialist palliative care (SPC) provision

Sample characteristics and median distances to nearest hospital, care home and hospice. (DOCX 16 kb

Additional file 1: of Mismatch between physicians and family members views on communications about patients with chronic incurable diseases receiving care in critical and intensive care settings in Georgia: a quantitative observational survey

Distribution of responses from physicians and patients’ family members to question 1.1 and 1.2. Figure S2. Distribution of responses from physicians and patients’ family members to question 1.2 and 2.2. Figure S3. Distribution of responses from physicians to question 1.3. Figure S4. Distribution of responses from physicians and patients’ family members to question 1.4 and 2.4. Figure S5. Distribution of responses from physicians and patients’ family members to question 1.5 and 2.5. Figure S6. Distribution of responses from physicians and patients’ family members to question 1.6 and 2.6. Figure S7. Distribution of responses from physicians and patients’ family members to question 1.7 and 2.7. Figure S8. Distribution of responses from physicians and patients’ family members to question 1.8 and 2.8. Figure S9. Distribution of responses from physicians and patients’ family members to question 1.9 and 2.9. Figure S10. Distribution of responses from physicians and patients’ family members to question 1.10 and 2.10. (ZIP 702 KB

Developing a generic business case for an advanced chronic liver disease support service

Introduction Liver disease deaths are rising but specialist palliative care services for hepatology are limited. Expansion across the NHS is required. MethodsWe surveyed clinicians, patients and carers to design an “ideal” service. Using standard NHS tariffs we calculated the cost of this service. In hospitals where specialist palliative care was available for liver disease, Patient level costs and bed utilisation in LYOL were compared between those seen by specialist palliative care before death and those not. ResultsThe “ideal” service was described. Costs were calculated as WTE for a minimal service which could be scaled up. From a hospital with an existing service, patients seen by specialist palliative care had associated costs of £14,728 in LYOL, compared with £18,558 for those dying without. Savings more than balanced the costs of introducing the service. Average bed days per patient in LYOL were reduced (19.4 vs 25.7) also ICU bed days (1.1 vs 1.8). Despite this, time from 1st admission in LYOL to death was similar in both groups (6 months for the specialist palliative care group vs 5 for those not referred). ConclusionsWe have produced a template business case for an “ideal” advanced liver disease support service, which self-funds and saves many bed days. The model can be easily adapted for local use in other trusts. We describe the methodology for calculating patient level costs and the required service size. We present a financially compelling argument to expand a service to meet a growing need.</p

Developing a generic business case for an advanced chronic liver disease support service

Introduction Liver disease deaths are rising but specialist palliative care services for hepatology are limited. Expansion across the NHS is required. MethodsWe surveyed clinicians, patients and carers to design an “ideal” service. Using standard NHS tariffs we calculated the cost of this service. In hospitals where specialist palliative care was available for liver disease, Patient level costs and bed utilisation in LYOL were compared between those seen by specialist palliative care before death and those not. ResultsThe “ideal” service was described. Costs were calculated as WTE for a minimal service which could be scaled up. From a hospital with an existing service, patients seen by specialist palliative care had associated costs of £14,728 in LYOL, compared with £18,558 for those dying without. Savings more than balanced the costs of introducing the service. Average bed days per patient in LYOL were reduced (19.4 vs 25.7) also ICU bed days (1.1 vs 1.8). Despite this, time from 1st admission in LYOL to death was similar in both groups (6 months for the specialist palliative care group vs 5 for those not referred). ConclusionsWe have produced a template business case for an “ideal” advanced liver disease support service, which self-funds and saves many bed days. The model can be easily adapted for local use in other trusts. We describe the methodology for calculating patient level costs and the required service size. We present a financially compelling argument to expand a service to meet a growing need.</p