Hospice shared-care saved medical expenditure and reduced the likelihood of intensive medical utilization among advanced cancer patients in Taiwan - A nationwide survey
Journal
Supportive Care in Cancer
Journal Volume
22
Journal Issue
7
Pages
1907-1914
Date Issued
2014
Author(s)
Lin W.-Y.
Ho C.-T.
Davidson L.E.
Hsu H.-S.
Liu C.-S.
Chiu C.-F.
Peng C.-T.
Chen C.-Y.
Hsu L.-N.
Li C.-I.
Li T.-C.
Lin C.-Y.
Chen C.-Y.
Lin C.-C.
Abstract
Purpose: Hospice shared care (HSC) is a new care model that has been adopted to treat inpatient advanced cancer patients in Taiwan since 2005. Our aim was to assess the effect of HSC on medical expenditure and the likelihood of intensive medical utilization by advanced cancer patients. Methods: This is a nationwide retrospective study. HSC was defined as using "Hospice palliative care (HPC) teams to provide consultation and service to advanced cancer patients admitted in the nonhospice care ward." There were 120,481 deaths due to cancer between 2006 and 2008 in Taiwan. Patients receiving HSC were matched by propensity score to patients receiving usual care. Of the 120,481 cancer deaths, 12,137 paired subjects were matched. Medical expenditures for 1 year before death were assessed between groups using a database from the Bureau of National Health Insurance. Paired t and McNemar's tests were applied for comparing the medical expenditure and intensive medical utilization before death between paired groups. Results: Compared to the non-HSC group, subjects receiving HSC had a lower average medical expenditure per person (US$3,939 vs. US$4,664; p<0.001). The HSC group had an adjusted net savings of US$557 (13.3 %; p<0.001) in inpatient medical expenditure per person compared with the non-HSC group. Subjects that received different types of HPC had 15.4-44.9 % less average medical expenditure per person and significantly lower likelihood of intensive medical utilization than those that did not receive HPC. Conclusions: HSC is associated with significant medical expenditure savings and reduced likelihood of intensive medical utilization. All types of HPC are associated with medical expenditure savings. ? 2014 Springer-Verlag.
Subjects
Advanced cancer; Hospice shared care; Medical expenditure; Palliative care
SDGs
Other Subjects
advanced cancer; article; cancer patient; controlled study; health care cost; health care utilization; health survey; hospice care; hospice palliative care; hospice shared care; human; major clinical study; palliative therapy; priority journal; propensity score; Taiwan; Health Expenditures; Hospice Care; Hospitalization; Humans; Inpatients; National Health Programs; Neoplasms; Palliative Care; Propensity Score; Referral and Consultation; Retrospective Studies; Taiwan
Publisher
Springer Verlag
Type
journal article