Economic evaluation
No significant effect of advance care planning on the primary effect outcome measures (quality of life and symptoms) was found.We investigated the difference in use of hospital care and associated costs between the study groups from a hospital perspective. To analyse the costs of healthcare use during 12 months after inclusion, we collected detailed information on hospital care consumption, including emergency department (ED) visits, hospital stays, ICU care; diagnostic procedures (e.g. blood transfusion or CT scan), medical interventions (e.g. surgery or CPR), and medication. Data were collected from participants’ hospital files using a standardised checklist. This checklist (A manual was developed in the project, in which we described in detail which unit prices for hospital care, diagnostic procedures, and medical interventions should be collected. The preferred perspective was the hospital perspective. The preferred source were national guidelines, providing reference prices as a proxy for real costs, followed by pricelists of hospitals. A reference price is an average unit price as estimated on the basis of large, diverse populations that can be directly used to value resource quantities. All countries provided unit prices based on this manual, as far as possible.Direct costs of medical care were calculated by multiplying their quantity with the corresponding unit prices per country. If unit prices were unavailable for a country, the price was calculated as the mean of the available reference prices for other countries. The mean was then corrected for the purchasing power parities (PPP) for general domestic product (GDP) per country. Costs were adjusted for inflation and reported in 2018 euros. Finally, unit prices per country were used to calculate overall costs.