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Is Hospital Hospice Service Associated with Efficient Healthcare Utilization in Deceased Lung Cancer Patients? Hospital Charges at Their End of Life

Author

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  • Dong Jun Kim

    (Division of Cancer Control and Policy, National Cancer Center, Goyang 10408, Republic of Korea)

  • Sun Jung Kim

    (Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan 31538, Republic of Korea
    Center for Healthcare Management Science, Soonchunhyang University, Asan 31538, Republic of Korea
    Department of Software Convergence, Soonchunhyang University, Asan 31538, Republic of Korea)

Abstract

In July 2015, South Korea began applying National Health Insurance reimbursement to inpatient hospice service. It is now appropriate and relevant to evaluate how hospice care is associated with healthcare utilization in terminal lung cancer patients. We used nationwide NHI claims data of lung cancer patients from 2008–2018 and identified a sample of patients deceased after July 2016. We transposed the dataset into a retrospective cohort design where a unit of analysis was each lung cancer patients’ healthcare utilization. The differences in hospital charges per day were investigated depending on the patient’s use of hospice service before death with the Generalized Linear Model (GLM) analysis. Additionally, subgroup analysis and the propensity score matching method were used to validate the model using the claims information of 25,099 patients. About 17.0% of patients used hospice services ( N = 4260). With other variables adjusted, hospice service utilization by deceased lung cancer patients was associated with statistically significant lower hospital charges per day at the end of life (1 month, 3 months, and 6 months before death) compared to non-users. A similar trend was found in the propensity score matching model analysis. We found lower end-of-life hospital charges per day among lung cancer patients who received hospice services near death. The ever-expanding aging population requires health policymakers and the National Health Insurance program to expand hospice services for terminal cancer patients in underserved regions and hospitals that do not provide hospice.

Suggested Citation

  • Dong Jun Kim & Sun Jung Kim, 2022. "Is Hospital Hospice Service Associated with Efficient Healthcare Utilization in Deceased Lung Cancer Patients? Hospital Charges at Their End of Life," IJERPH, MDPI, vol. 19(22), pages 1-10, November.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:22:p:15331-:d:978507
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    References listed on IDEAS

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    1. Jui-Kun Chiang & Yee-Hsin Kao & Ning-Sheng Lai, 2015. "The Impact of Hospice Care on Survival and Healthcare Costs for Patients with Lung Cancer: A National Longitudinal Population-Based Study in Taiwan," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-19, September.
    2. Obermeyer, Ziad & Makar, Maggie & Abujaber, Samer & Dominici, Francesca & Block, Susan Dale & Cutler, David M., 2014. "Association Between the Medicare Hospice Benefit and Health Care Utilization and Costs for Patients With Poor-Prognosis Cancer," Scholarly Articles 22856726, Harvard University Department of Economics.
    3. Kim, Jaehoon & Kim, Sangsin, 2015. "2012년 국회법 개정의 효과 연구 [A Study on the Effect of the 2012 National Assembly Act Amendment]," KDI Research Monographs, Korea Development Institute (KDI), volume 127, number v:2015-03(k):y:2015:p:1-1.
    4. DiMasi, Joseph A. & Hansen, Ronald W. & Grabowski, Henry G., 2003. "The price of innovation: new estimates of drug development costs," Journal of Health Economics, Elsevier, vol. 22(2), pages 151-185, March.
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