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Does hospital need more hospice beds? Hospital charges and length of stays by lung cancer inpatients at their end of life: A retrospective cohort design of 2002-2012

 Sun Jung Kim  ;  Kyu-Tae Han  ;  Tae Hyun Kim  ;  Eun-Cheol Park 
 PALLIATIVE MEDICINE, Vol.29(9) : 808-816, 2015 
Journal Title
Issue Date
Adult ; Aged ; Female ; Hospice Care/economics ; Hospice Care/organization & administration* ; Hospital Bed Capacity/economics* ; Hospital Bed Capacity/statistics & numerical data ; Hospital Charges/statistics & numerical data* ; Humans ; Length of Stay/statistics & numerical data* ; Lung Neoplasms/economics* ; Lung Neoplasms/therapy ; Male ; Middle Aged ; Palliative Care/economics* ; Palliative Care/organization & administration ; Republic of Korea ; Retrospective Studies ; Terminal Care/economics* ; Terminal Care/organization & administration
Hospice care ; fees and charges ; length of stay ; lung neoplasms
BACKGROUND: Previous studies found that hospice and palliative care reduces healthcare costs for end-of-life cancer patients. AIM: To investigate hospital inpatient charges and length-of-stay differences by availability of hospice care beds within hospitals using nationwide data from end-of-life inpatients with lung cancer. DESIGN: A retrospective cohort study was performed using nationwide lung cancer health insurance claims from 2002 to 2012 in Korea. SETTING AND PARTICIPANTS: Descriptive and multi-level (patient-level and hospital-level) mixed models were used to compare inpatient charges and lengths of stay. Using 673,122 inpatient health insurance claims, we obtained aggregated hospital inpatient charges and lengths of stay from a total of 114,828 inpatients and 866 hospital records. RESULTS: Hospital inpatient charges and length of stay drastically increased as patients approached death; a significant portion of hospital inpatient charges and lengths of stay occurred during the end-of-life period. According to our multi-level analysis, hospitals with hospice care beds tend to have significantly lower end-of-life hospital inpatient charges; however, length of stay did not differ. Hospitals with more hospice care beds were associated with reduction in hospital inpatient charges within 3 months before death. CONCLUSION: Higher end-of-life healthcare hospital charges were found for lung cancer inpatients who were admitted to hospitals without hospice care beds. This study suggests that health policy-makers and the National Health Insurance program need to consider expanding the use of hospice care beds within hospitals and hospice care facilities for end-of-life patients with lung cancer in South Korea, where very limited numbers of resources are currently available.
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Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
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