| Summary: | 碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 107 === Background: The aging population in Taiwan is rising quickly, hence the demand for hospice care is increasing. Since 2009, eight categories of non-cancer terminal diseases have been included in health insurance payment, which has made hospice care accessible to more people. In the past, the discussion of hospice care only focused on patients with end-of-life cancer. This study fills up the gap and explores the impact of hospice care expenses and utilization on both cancer and non-cancer patients. Methods: The data obtained from the Million People File was a study on 5062 adult patients who died of cancer or one of the eight-category non-cancers in 2012. Using multivariate logistic regression and linear regression verifies the use of hospice care for end-of-life aggressive care utilization and overall medical expenses.
Results: End-of-life patients with hospice treatment can receive fewer aggressive treatments 30 days prior to death. Declining indicators include reducing the use of acute intensive care units, intubation, mechanical ventilation, cardiopulmonary resuscitation, and death in a hospital. In medical expenses, use hospice care can reduce total medical expenses of the final month before the patients'' death. Conclusion: In general, the rate of aggressive care before death for end-of-life patients using hospice care shows a decline. End-of-life patients who treated with hospice care show better care quality and less medical utilization, and the total medical expenses on hospice care dropped at the final month prior to death.
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