Effects of Hospitalized Medical Expenditure and Length-of-Stay on End-of-Life Care Patterns in Hospitalized Cancer Patients

• Main Authors: Chien-Ming Lo, 羅健銘
• Other Authors: Chien-Jen Chen
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/10674018446111630094

碩士 === 國立台北護理學院 === 醫護管理研究所 === 93 === Background: Cancer, cardiopathy, cerebrovascular, diabetes and accidents are the five leading causes of death according to Health Statistics by the Department of Health in Taiwan . Cancer has also been the leading cause of death in Taiwan for years. Besides curative treatments, terminally ill patients suffering from cancers can choose hospice as a medical treatment. Hospice aims to provide patients with a professional medication which emphasizes that patients have to be taken care of physically, emotionally and spiritually. Little research has been done with hospice data of National Health Insurance in Taiwan although hospice has become one of standardized medication for terminal ill patients suffering from cancer in the unit state. Objective: This study is to evaluate the effects of hospitalized medical expenditure and length-of-stay on end-of-life care patterns in hospitalized cancer patients. Data sources: The data sources of this study were mainly from “Inpatient expenditures by admissions” and “Registry for contracted medical facilities” of the National Health Insurance Research Database, National Health Research Institutes. There were 23,833 subjects who met criteria of this study for analysis. Methods: Length-of-stay was compared between hospice and conventional medication of terminally hospitalized cancer patients. Multiple regression analysis was further used to predict medical expenditure. Results: In terms of length-of-stay, hospice patients’ length-of-stay was shorter than those of non-hospice patients’ (16 days v. s. 23 days). Those who chose to stay in a medical center or received an operation tended to have higher length-of-stay regardless if they were hospice or non-hospice patients. However, those who suffered from liver cancer tended to have a shorter length-of-stay no matter what kind of care patterns. As for medical expenditure of hospice and non-hospice care patterns, the medical expenditure of hospice was obviously lower than those of non-hospice except for general hospitalized expenditure of operated patients. Conclusions and suggestions: The results of this study indicate that medical expenditure was lower when terminally hospitalized cancer patients chose to have hospice as their care pattern. Further research is suggested to investigate the quality and survival of hospice so that it can be widely promoted in the future in Taiwan. Limitation: Cancer stages were not included in the data file of National Health Insurance. Keywords: hospice, cancer, medical expenditure, length-of-stay.