HEALTH CARE USE AND OUT-OF-POCKET COSTS FOR RURAL FAMILY CAREGIVERS AND CARE RECIPIENTS IN TRANSITIONAL PALLIATIVE CARE

Kaufman B, Huang R, Holland D, Vanderboom C, Mandrekar J, Gustavson A, Griffin J. HEALTH CARE USE AND OUT-OF-POCKET COSTS FOR RURAL FAMILY CAREGIVERS AND CARE RECIPIENTS IN TRANSITIONAL PALLIATIVE CARE. Innovation in aging. 2024 Dec 31; 8(Suppl 1):645-646, DOI: https://doi.org/10.1093/geroni/igae098.2113.

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Abstract:

Few studies have reliable estimates on costs of informal care following hospitalization, including health care use and out-of-pocket costs for family caregivers (FCGs) and their care recipients (CR). This presentation discusses results from a Transitional Palliative Care (TPC) intervention on healthcare use and out-of-pocket spending for both FCGs and CRs. The study used data from the Technology-Enhanced TPC study, a trial comparing the TPC intervention to support FCGs of seriously ill CRs to an attention control condition. TPC FCGs received teaching, guidance, and counseling via video calls for 8 weeks following CR hospital discharge. After discharge, a research assistant called FCGs once a month for up to 6 months or CR death to collect healthcare utilization (e.g. outpatient, emergency department, and hospital), out-of-pocket healthcare spending (e.g. deductibles and coinsurance), and health-related travel costs (e.g., transportation, lodging, food) for FCGs and CRs. Incidence rate ratios (IRR) were estimated using negative binomial regressions. The study included 282 FCG-CR dyads across 3 US states. TPC reduced nights in the hospital for CR (IRR = 0.75; 95% CI = 0.56 - 0. 99). Total out-of-pocket spending was not significantly different for TPC versus control; however, TPC dyads reported lower lodging costs (IRR = 0.71; 95% CI = 0.56-0.89). Across groups, mean out-of-pocket spending for dyads was Math input error 1048.58 and transportation expenses contributing $136.79. This study contributes to evidence that palliative care interventions reduce unnecessary hospitalization for seriously ill patients, yet the financial costs to caregivers remain high.