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.

Citations

Citations to this article as recorded by  

• The Perceptions and Needs of Hospice Palliative Care and Shared Decision Making among Middle-Aged Adults
  Na-Yeon Lee, Seungjin Lee, Soo-Kyoung Lee
  The Korean Journal of Hospice and Palliative Care.2016; 19(4): 310.     CrossRef
• Effects of Integrated Palliative Care Intervention on Quality of Life in Terminal Cancer Patients: A Meta-analysis
  Kae Hwa Jo, Ae Ran Park, Jin Ju Lee
  The Korean Journal of Hospice and Palliative Care.2015; 18(2): 136.     CrossRef
• Home hospice palliative care service in Korea: Based on focus group interview
  Su-Jin Koh, Yeol Kim, Mi Ok Song, Youngsim Choi, Sung Eun Choi, Hyun Jung Jho, Yun Jung Huh, Myung-Hee Park, Seon Ju Park, So-Hi Kwon
  Journal of the Korean Data and Information Science Society.2014; 25(1): 37.     CrossRef
• Comparison in Spiritual Well-being and Quality of Life between Hospital and Home Hospice Patients
  Bok Hee Kim, Heeok Park
  Journal of Korean Academy of Community Health Nursing.2013; 24(3): 292.     CrossRef
• Comparison of the Hospice Systems in the United States, Japan and Taiwan
  Chung Yul Lee, Hiroko Komatsu, Weihua Zhang, Yann-Fen Chao, Ki Kyong Kim, Gwang Suk Kim, Yoon Hee Cho, Ji Sook Ko
  Asian Nursing Research.2010; 4(4): 163.     CrossRef
• Hospice and Hospice Care in Korea: Evolution, Current Status, and Challenges
  Bok Yae Chung, Yu Xu, Chanyeong Kwak
  Home Health Care Management & Practice.2005; 18(1): 73.     CrossRef
• Introducing Economic Evaluation as a Policy Tool in Korea: Will Decision Makers get Quality Information?
  Kun-Sei Lee, Werner B F Brouwer, Sang-Il Lee, Hye-Won Koo
  PharmacoEconomics.2005; 23(7): 709.     CrossRef