Effect of hospice care use on the utilization and expenses of care for end-of-life patients with and without cancer
Journal
Taiwan Journal of Public Health
Journal Volume
39
Journal Issue
2
Pages
187-201
Date Issued
2020-04-01
Author(s)
Abstract
© 2020 Chinese Public Health Association of Taiwan. All rights reserved. Objectives: The demand for hospice care is increasing because of the rapidly aging population in Taiwan. Since 2009, health insurance payments have been expanded to cover eight categories of noncancer terminal diseases, thus making hospice care accessible to more people. Previous discussions on hospice care have focused only on patients with end-of-life cancer, to the neglect of other patients. This study fills this gap by exploring the effect of hospice care expenses and utilization on patients with cancer and patients with noncancer terminal diseases. Methods: Data were obtained from the Million People File - a study of 5,062 adult patients with either cancer or diseases in one of the eight categories of noncancer terminal diseases who died in 2012. Multivariate logistic regression and linear regression were used to verify the use of hospice care for end-of-life aggressive care utilization and overall medical expenses. Results: End-of-life patients receiving hospice care used fewer aggressive treatments 30 days prior to death, including use of intensive care units, intubations, mechanical ventilation, and cardiopulmonary resuscitation, and were less likely to die in a hospital. The use of hospice care reduced the total cost of medical care in the final months before death. Conclusions: In general, for end-of-life patients receiving hospice care, the use of aggressive care before death has been declining. End-of-life patients treated with hospice care had better care quality and less medical utilization. The total medical expenses for hospice care decreased during the final month prior to death.
Subjects
Care quality | End of life patients | Hospice care | Medical expenses | Medical utilization
Care quality; End of life patients; Hospice care; Medical expenses; Medical utilization
SDGs
Publisher
Taiwan Public Health Association
Type
journal article