Untangling the relationship between health and social care spending in the last year of life

Increasingly, death is pushed to older ages. As individuals approach death, the number of organ systems affected by disease increases, functional decline accelerates, and the number of parts of the health and social care systems involved in care rises. The Swedish health and social care systems have changed over time and it has become more difficult to navigate and coordinate care from multiple providers. This leads to a more stressful experience and poorer perception of quality of care for patients and their caregivers, along with heightening socioeconomic differences in the use of care in the last year of life.

Health and social care use tend to be higher in the last year of life, and as such care expenditure often increases dramatically. By linking population-based registers we can retrospectively measure care expenditure in the last year of life. Through this project we will gain insight into how care resources are used and what expenditures are associated, to highlight resource intensive areas and uncover inefficiencies in the borderland between the health and social care systems. This project aims to investigate the interaction between health and social care services from an expenditure perspective, and explore how the distribution of care resources differs between socioeconomic and demographic groups in the last year of life. To improve the delivery of health and social care to meet the changing needs of the population, it is essential to understand the patterns of care resource usage at the end stage of life.

The project will be conducted with collaborators with a range of expertise in public health, health care and social care systems, and health economics, from Karolinska Institutet, Stockholm University and Uppsala University.it also involves international collaboration, and Megan will spend some time as a visiting researcher at the London School of Economics during the project.

Duration: Two years, starting in January 2023