Lay summary
Almost three-quarters of total life-long healthcare costs occur in the last three years of life. Although most healthcare in old age is necessary, many older people/Kaumātua and their family/whānau would decline certain interventions in order to live their last days peacefully in their own homes. This mixed-methods study will explore how older people/Kaumātua, their family/whānau, as well as hospital-based clinicians decide what health service interventions are offered in the last year of life. The mixed-methods study will collect qualitative data on how informed-decisions concerning treatment options are made in hospital through interviews with: (i) older people/kaumātua and their family/whānau; and (ii) health professionals. Hospital costing data will also be analysed to enable patient level costs, for those in their last year of life, to be generated. The outputs of this research will inform a large-scale intervention study examining advanced care plans for older people and will include a cost-benefit analysis.