The impact of hospice care on survival and cost saving among patients with liver cancer: a national longitudinal population-based study in Taiwan

@article{Chiang2014TheIO,
  title={The impact of hospice care on survival and cost saving among patients with liver cancer: a national longitudinal population-based study in Taiwan},
  author={Jui-Kun Chiang and Yee-Hsin Kao},
  journal={Supportive Care in Cancer},
  year={2014},
  volume={23},
  pages={1049-1055}
}
PurposeThe aim of this study was to compare health-care expenditures and survival of these terminally ill patients receiving or not receiving hospice care in their last month of life.MethodsUsing Taiwan’s National Health Insurance Claims Database, we analyzed hospitalizations, OPD visits, associated costs, and survival. Logistic regression was used to identify predictors of high cost.ResultsWe identified 3850 liver cancer patients who died during the 1997–2011 study period, 644 (16.6 %) of whom… 
View on Springer
mascc.org
18 Citations
Background Citations
4
Methods Citations
1
Results Citations
2

18 Citations

Effect of hospice care on health-care costs for Taiwanese patients with cancer during their last month of life in 2004–2011: A trend analysis

Health-care costs in the last month of life are increasing over time in Taiwan, and patients receiving hospice care can be as much as 16.3% lower than patients not receiving Hospice care.

Differences in medical costs for end-of-life patients receiving traditional care and those receiving hospice care: A retrospective study

Hospice care can effectively save a large amount of end-of-life medical costs, and more medical costs are saved when patients are referred to hospice care earlier.

Costs of care at the end of life among elderly patients with chronic kidney disease: patterns and predictors in a nationwide cohort study

Overall EOL costs and rates of intensive service use among older patients with CKD were high, with significant variability across various patient and provider characteristics.

How we use hospice: Hospice enrollment patterns and costs in elderly ovarian cancer patients.

Predicting 1-year mortality among patients with decompensated cirrhosis: results of a multicentre evaluation of the Bristol Prognostic Score

BPS was unable to accurately predict mortality in this Scottish cohort, highlighting the ongoing challenge of prognostication in patients with chronic liver disease and furthering the call for more work in this field.

Palliative Care and Hospice Interventions in Decompensated Cirrhosis and Hepatocellular Carcinoma: A Rapid Review of Literature.

It is suggested that PC and hospice interventions in patients with DC/HCC reduce HRU, impact EOLC, and improve symptoms, given the few number of studies, heterogeneity of interventions and outcomes, and high risk of bias.

Hospice care for end stage liver disease in the United States

This review examines the evidence support for hospice for ESLD, compares this evidence to that supporting hospice more broadly, and identifies potential criteria that may be useful in determining hospice appropriateness.

Cancer survival in Qidong between 1972 and 2011: A population-based analysis.

Improved survival rates in the most recent two 5-year calendar periods were identified for stomach, lung, colon and rectum, oesophagus, female breast and bladder cancer, as well as leukaemia and NHL.

Economic Implications of Hepatocellular Carcinoma Surveillance and Treatment: A Guide for Clinicians

A focused review of studies investigating the economic burden and cost effectiveness of HCC surveillance treatment modalities published between January 2000 and January 2019 found that Liver transplantation is a cost-effective strategy for early-stage HCC treatment in selected patients.

The Cost Effectiveness of Donafenib Compared With Sorafenib for the First-Line Treatment of Unresectable or Metastatic Hepatocellular Carcinoma in China

Donafenib is unlikely to be cost effective compared with sorafenIB for the first-line treatment of unresectable or metastatic HCC in China and reducing the price of donafen ib can increase the possibility of it being cost effective in the future.

References

SHOWING 1-10 OF 26 REFERENCES

Association of healthcare expenditures with aggressive versus palliative care for cancer patients at the end of life: a cross-sectional study using claims data in Japan.

Indicators of both aggressive and palliative EOL care were associated with higher healthcare expenditures, which may support the coherent development of measures to optimize aggressive care and reduce the financial burdens of terminal cancer care.

Hospice shared-care saved medical expenditure and reduced the likelihood of intensive medical utilization among advanced cancer patients in Taiwan—a nationwide survey

HSC is associated with significant medical expenditure savings and reduced likelihood of intensive medical utilization by advanced cancer patients and all types of HPC are associated withmedical expenditure savings.

Trends in quality of end-of-life care for Taiwanese cancer patients who died in 2000-2006.

The quality of end-of-life care for Taiwanese cancer decedents was substantially inferior to that previously reported and to that recommended as benchmarks for not providing overly aggressive care near the end of life.

Resource consumption and costs of palliative care services in Spain: a multicenter prospective study.

Hospice care and survival among elderly patients with lung cancer.

Hospice enrollment did not compromise length of survival following advanced lung cancer diagnosis and patients experiencing short-term hospice admissions within 3 days of death received less aggressive end-of-life care compared to nonhospice patients.

Comparing hospice and nonhospice patient survival among patients who die within a three-year window.

Impact of hospice disenrollment on health care use and medicare expenditures for patients with cancer.

Hospitalization, emergency department, and intensive care unit admission and hospital death for hospice disenrollees and those who remained with hospice until death and per-day Medicare expenditures across the two groups are compared.

Trends in the aggressiveness of cancer care near the end of life.

The treatment of cancer patients near death is becoming increasingly aggressive over time and greater local availability of hospices was associated with less aggressive treatment near death on multivariate analysis.

Multivariate Analyses to Assess the Effects of Surgeon and Hospital Volume on Cancer Survival Rates: A Nationwide Population-Based Study in Taiwan

After adjusting for differences in the case mix, cancer patients treated by low-volume surgeons in low- volume hospitals had poorer 5-year survival rates, and patients’ demographic variables, co-morbidities, and treatment modality may need to be adjusted for.

Cost savings at the end of life. What do the data show?

The existing data suggest that hospice and advance directives can save between 25% and 40% of health care costs during the last month of life, with savings decreasing to 10% to 17% over the last 6 months of life and decreasing further to 0% to 10%, less than most people anticipate.