As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to
devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better
care at the end of life, hospice care has recently received significant attention as a mean of reducing health care
costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since
the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and
concerns of many dying people and their families is limited The purpose of this study was to determine the
potential cost savings at the end of life among patients who used home hospice compared with the patients who
received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study
included 46 patients who died of lung cancer:
25 patients who received home hospice care and 21 patients who received institutional care. Data on patient
characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital
charges during the last month before death were collected. Cost of care was measured by the average cost per
patient per day in the last month of life.
The results of the study indicated that there were significant differences in average cost of care between home
hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional
care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of
institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive
counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%),
treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than
education or supportive counseling among the nursing services provided. The results of this study showed the
potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice
program into the formal health care delivery system in Korea.