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Title: Exploring the economics of care at the end of life
Author: Round, J. A.
ISNI:       0000 0004 7660 111X
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2016
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The economics of end-of-life and palliative care is of increasing interest to health economists. It is an important clinical area and one that will place greater demands on scarce health- and social care resources in coming years. As more people are living into old age than ever before and as the population age profile skews higher, there will be an increase in the number of people experiencing diseases associated with older age, and thus an increased demand for care of all types. People will spend longer with care needs at the end of life, and understanding the cost of this care and how it is provided is important. This thesis considers how care for people at the end of life is produced and there are three overall aims. The first aim is to describe the system of production of end-of-life care in the UK and to estimate the cost of providing that care. I show that the costs of caring for people at the end of their lives are significant, and that charity-provided care and informal caregiving are important complements to the formal health- and social care system. The second aim is to investigate the specific role of informal caregivers in the production of end-of-life care. I show that informal caregiving behaviour is driven by labour market conditions of the caregiver. Those in employment are less likely to provide care than those not in employment. In addition, those in employment who do provide care provide fewer hours on average than those not in employment. The final aim is to investigate health and wellbeing in people at the end of life and their informal caregivers. Under this aim I first consider the argument for the most appropriate way to measure and value health outcomes in economic evaluations concerning people at the end of life. I then consider the impact of caregiving on the health and wellbeing of caregivers. I show that informal caregiving has a statistically significant negative impact on informal caregivers' health and wellbeing. However, I also show that while statistically significant, the effect is generally small and may not be clinically meaningful.
Supervisor: Morris, S. ; Jones, C. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available