Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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Comparison of Medical Care Cost between Hospice Care and Conventional Care in the Last Year of life

호스피스케어와 전통적 의료서비스 이용간의 사망전 의료비용 비교

  • Choi Kui Son (National Cancer Center, Research Institute for National Cancer Control and Evaluation) ;
  • You Chang Hoon (National Cancer Center, Research Institute for National Cancer Control and Evaluation) ;
  • Lee Kyoung Hee (Seoul National University, School of Public Health) ;
  • Kim Chang Yup (Seoul National University, School of Public Health) ;
  • Heo Dae Seog (Seoul National University Hospital, Department of Internal Medicine) ;
  • Yun Young Ho (National Cancer Center, Research Institute for National Cancer Control and Evaluation)
  • 최귀선 (국립암센터 국가암관리사업지원평가연구단) ;
  • 유창훈 (국립암센터 국가암관리사업지원평가연구단) ;
  • 이경희 (서울대학교 보건대학원) ;
  • 김창엽 (서울대학교 보건대학원) ;
  • 허대석 (서울대학교병원 내과) ;
  • 윤영호 (국립암센터 국가암관리사업지원평가연구단)
  • Published : 2005.06.01
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Abstract

The aim of this study was to compare medical cost of hospice care and that of conventional care during the last year of life, and identify factors that influenced the cost. From January to August 2003 592 terminal cancer patients receiving care from 5 hospice care units and 2 hospice care teams in general hospitals were enrolled to case group. Two hundreds and seventy two terminal cancer patients receiving conventional care from 7 general hospitals were enrolled to hospital-based control group, and 1,636 terminal cancer patients from 122 general hospitals located in same regions with the 7 hospitals were enrolled to community-based control. We used characteristics and medical cost from data of National Health Insurance Cooperation. Total medical cost per beneficiary in cases was about 10 millions won, 14.5 millions in hospital-based controls and 11.1 millions in community-based controls. The hospice care saved $45\%$ over the last year of life compared with hospital-based controls (p<0.0001). Saving of inpatient cost account for approximately $80\%$ of saving per beneficiary. Hospice care saved $29\%$ of medical cost per hospitalization day compared with hospital­based controls and $17\%$ compared with community-based controls (p<0.0001). Multiple regression analyses showed that hospice care significantly saved the medical cost. This study suggest that hospice care save medical cost compared with hospital-based control and community-based control. Most of saving of inpatient cost account for approximately $80\%$ of saving of medical cost.

Keywords

References

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