Dr Brett Doble, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore

As the proportion of the population that is older than 65 years of age continues to grow, the number of patients living with cognitive impairment will increase. As patients age, cognitive impairment will progress and eventually these patients will receive end-of-life (EOL) care.

Providing EOL care for patients with evidence of cognitive impairment poses unique challenges including predisposition to infections, poor compliance to treatment and presence of co-morbidities. These factors could potentially result in large healthcare costs in EOL for these groups of patients.

The aim of this project is to look at healthcare utilisation, associated costs, the appropriateness of care and any differences in these outcomes between patients with and without evidence of cognitive impairment in the last year of life.

The team aim to quantify these outcomes or differences using MOH Mediclaims utilization and cost data and linking a subset of this data to the Singapore Chinese Health Study.

The findings will allow for a better understanding of end-of-life experiences, forecasting of future costs/utilization, appropriate setting of subsidies and identification of opportunities to improve end-of-life care for patients with evidence of cognitive impaired.

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