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Health economics of a palliative care unit for terminal cancer patients: a retrospective cohort study
Purpose The objective of this study was to evaluate cost-reduction efficacy of a palliative care unit (PCU) by analyzing medical expenses of terminal cancer patients. Methods Hospital bills and medical records of 656 patients who died of cancer from January to December 2007 at one university hospita...
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| Published in: | Supportive care in cancer 2012-01, Vol.20 (1), p.29-37 |
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| container_title | Supportive care in cancer |
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| creator | Jung, Hyun-myung Kim, Jinhyun Heo, Dae Seog Baek, Sun Kyung |
| description | Purpose
The objective of this study was to evaluate cost-reduction efficacy of a palliative care unit (PCU) by analyzing medical expenses of terminal cancer patients.
Methods
Hospital bills and medical records of 656 patients who died of cancer from January to December 2007 at one university hospital in Seoul were analyzed.
Results
Of the total 656 patients, 126 died in the PCU. Compared to non-PCU patients, PCU patients were more likely to permit do-not-resuscitate (DNR), visit the emergency room (ER), and receive palliative chemotherapy (
P
|
| doi_str_mv | 10.1007/s00520-010-1047-y |
| format | article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_906152048</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A357967335</galeid><sourcerecordid>A357967335</sourcerecordid><originalsourceid>FETCH-LOGICAL-c518t-76c34d7e8a7a80b2805b0b3074431c08aee6f5ebd632aaaf6b3aa99992117a623</originalsourceid><addsrcrecordid>eNp1kUFv1jAMhiPExL4NfgAXVHHh1M1pkqblNk1sQ5rEBc6Vm7pbprb5SFKk79_PoxtISCSHyM7zWvZrId5LOJMA9jwBmApKkFBK0LY8vBI7qZUqrVLta7GDVstSK2OOxUlKDwDSWlO9EceVlFxAm52gG8Ip3xfkwhJm71IRxgKLPU6Tx-x_UeEwUrEuPhdjiEWmOPsFJ04vjiKD2dOS02cWRcoxpD25TRfuQ8xFyutweCuORpwSvXt-T8WPqy_fL2_K22_XXy8vbktnZJNLWzulB0sNWmygrxowPfQKrNZKOmiQqB4N9UOtKkQc614htnx4Hot1pU7Fp63uPoafK6XczT45miZcKKypa6GW7JhumPz4D_kQ1siDPUGmtappNENnG3SHE3V-GUOO6PgOxFaFhUbP-QtlbFuz5YYFchM4NiJFGrt99DPGQyehe1pZt62sg9-xtt2BNR-eO1n7mYY_ipcdMVBtQOKv5Y7i31b_X_URB7Khhw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>905973884</pqid></control><display><type>article</type><title>Health economics of a palliative care unit for terminal cancer patients: a retrospective cohort study</title><source>Social Science Premium Collection</source><source>Springer Nature</source><source>Sociology Collection</source><creator>Jung, Hyun-myung ; Kim, Jinhyun ; Heo, Dae Seog ; Baek, Sun Kyung</creator><creatorcontrib>Jung, Hyun-myung ; Kim, Jinhyun ; Heo, Dae Seog ; Baek, Sun Kyung</creatorcontrib><description><![CDATA[Purpose
The objective of this study was to evaluate cost-reduction efficacy of a palliative care unit (PCU) by analyzing medical expenses of terminal cancer patients.
Methods
Hospital bills and medical records of 656 patients who died of cancer from January to December 2007 at one university hospital in Seoul were analyzed.
Results
Of the total 656 patients, 126 died in the PCU. Compared to non-PCU patients, PCU patients were more likely to permit do-not-resuscitate (DNR), visit the emergency room (ER), and receive palliative chemotherapy (
P
< 0.001,
P
= 0.045,
P =
0.002). The non-PCU patients were admitted to the intensive care unit (ICU), used a ventilator, and received hemodialysis more often (
P
< 0.001,
P
< 0.001,
P
< 0.001). Total medical cost per all patients within 6 months of death averaged $27,863. There was a significant difference in medical costs starting at 2 months before death between PCU and non-PCU patients. The medical cost of the PCU group was 32.8% lower 1 month before death and 33.0% lower 2 months before death than the non-PCU group (
P
< 0.001,
P
< 0.001). Patients using PCU services, those with solid cancers, and those with less than a high school education paid lower medical expenses (
P
< 0.05)
Conclusion
Cost savings of the PCU were verified. It was also determined that specific factors were tied to increased medical expenses during the last 6 months of life. If these parameters are controlled properly, additional cost savings, associated with palliative care could be realized.]]></description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-010-1047-y</identifier><identifier>PMID: 21110045</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Aged ; Analysis ; Cancer ; Cancer patients ; Care and treatment ; Chemotherapy ; Cohort Studies ; Cost Savings ; Do-not-resuscitate orders ; Economic aspects ; Emergency medical services ; Female ; Health Care Costs ; Health care expenditures ; Health economics ; Hospitals, University - economics ; Humans ; Intensive Care Units - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasms - economics ; Neoplasms - pathology ; Neoplasms - therapy ; Nursing ; Nursing Research ; Oncology ; Oncology, Experimental ; Original Article ; Pain Medicine ; Palliative care ; Palliative Care - economics ; Palliative Care - methods ; Palliative treatment ; Rehabilitation Medicine ; Republic of Korea ; Retrospective Studies ; Terminal Care - economics ; Terminal Care - methods ; Terminal illnesses</subject><ispartof>Supportive care in cancer, 2012-01, Vol.20 (1), p.29-37</ispartof><rights>Springer-Verlag 2010</rights><rights>COPYRIGHT 2012 Springer</rights><rights>Springer-Verlag 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c518t-76c34d7e8a7a80b2805b0b3074431c08aee6f5ebd632aaaf6b3aa99992117a623</citedby><cites>FETCH-LOGICAL-c518t-76c34d7e8a7a80b2805b0b3074431c08aee6f5ebd632aaaf6b3aa99992117a623</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/905973884/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/905973884?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,21373,21374,27901,27902,33588,33589,34507,34508,43709,44091,73964,74382</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21110045$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, Hyun-myung</creatorcontrib><creatorcontrib>Kim, Jinhyun</creatorcontrib><creatorcontrib>Heo, Dae Seog</creatorcontrib><creatorcontrib>Baek, Sun Kyung</creatorcontrib><title>Health economics of a palliative care unit for terminal cancer patients: a retrospective cohort study</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description><![CDATA[Purpose
The objective of this study was to evaluate cost-reduction efficacy of a palliative care unit (PCU) by analyzing medical expenses of terminal cancer patients.
Methods
Hospital bills and medical records of 656 patients who died of cancer from January to December 2007 at one university hospital in Seoul were analyzed.
Results
Of the total 656 patients, 126 died in the PCU. Compared to non-PCU patients, PCU patients were more likely to permit do-not-resuscitate (DNR), visit the emergency room (ER), and receive palliative chemotherapy (
P
< 0.001,
P
= 0.045,
P =
0.002). The non-PCU patients were admitted to the intensive care unit (ICU), used a ventilator, and received hemodialysis more often (
P
< 0.001,
P
< 0.001,
P
< 0.001). Total medical cost per all patients within 6 months of death averaged $27,863. There was a significant difference in medical costs starting at 2 months before death between PCU and non-PCU patients. The medical cost of the PCU group was 32.8% lower 1 month before death and 33.0% lower 2 months before death than the non-PCU group (
P
< 0.001,
P
< 0.001). Patients using PCU services, those with solid cancers, and those with less than a high school education paid lower medical expenses (
P
< 0.05)
Conclusion
Cost savings of the PCU were verified. It was also determined that specific factors were tied to increased medical expenses during the last 6 months of life. If these parameters are controlled properly, additional cost savings, associated with palliative care could be realized.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Cohort Studies</subject><subject>Cost Savings</subject><subject>Do-not-resuscitate orders</subject><subject>Economic aspects</subject><subject>Emergency medical services</subject><subject>Female</subject><subject>Health Care Costs</subject><subject>Health care expenditures</subject><subject>Health economics</subject><subject>Hospitals, University - economics</subject><subject>Humans</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasms - economics</subject><subject>Neoplasms - pathology</subject><subject>Neoplasms - therapy</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Oncology, Experimental</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Palliative care</subject><subject>Palliative Care - economics</subject><subject>Palliative Care - methods</subject><subject>Palliative treatment</subject><subject>Rehabilitation Medicine</subject><subject>Republic of Korea</subject><subject>Retrospective Studies</subject><subject>Terminal Care - economics</subject><subject>Terminal Care - methods</subject><subject>Terminal illnesses</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>ALSLI</sourceid><sourceid>HEHIP</sourceid><sourceid>M2R</sourceid><sourceid>M2S</sourceid><recordid>eNp1kUFv1jAMhiPExL4NfgAXVHHh1M1pkqblNk1sQ5rEBc6Vm7pbprb5SFKk79_PoxtISCSHyM7zWvZrId5LOJMA9jwBmApKkFBK0LY8vBI7qZUqrVLta7GDVstSK2OOxUlKDwDSWlO9EceVlFxAm52gG8Ip3xfkwhJm71IRxgKLPU6Tx-x_UeEwUrEuPhdjiEWmOPsFJ04vjiKD2dOS02cWRcoxpD25TRfuQ8xFyutweCuORpwSvXt-T8WPqy_fL2_K22_XXy8vbktnZJNLWzulB0sNWmygrxowPfQKrNZKOmiQqB4N9UOtKkQc614htnx4Hot1pU7Fp63uPoafK6XczT45miZcKKypa6GW7JhumPz4D_kQ1siDPUGmtappNENnG3SHE3V-GUOO6PgOxFaFhUbP-QtlbFuz5YYFchM4NiJFGrt99DPGQyehe1pZt62sg9-xtt2BNR-eO1n7mYY_ipcdMVBtQOKv5Y7i31b_X_URB7Khhw</recordid><startdate>20120101</startdate><enddate>20120101</enddate><creator>Jung, Hyun-myung</creator><creator>Kim, Jinhyun</creator><creator>Heo, Dae Seog</creator><creator>Baek, Sun Kyung</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120101</creationdate><title>Health economics of a palliative care unit for terminal cancer patients: a retrospective cohort study</title><author>Jung, Hyun-myung ; Kim, Jinhyun ; Heo, Dae Seog ; Baek, Sun Kyung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c518t-76c34d7e8a7a80b2805b0b3074431c08aee6f5ebd632aaaf6b3aa99992117a623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analysis</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Cohort Studies</topic><topic>Cost Savings</topic><topic>Do-not-resuscitate orders</topic><topic>Economic aspects</topic><topic>Emergency medical services</topic><topic>Female</topic><topic>Health Care Costs</topic><topic>Health care expenditures</topic><topic>Health economics</topic><topic>Hospitals, University - economics</topic><topic>Humans</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasms - economics</topic><topic>Neoplasms - pathology</topic><topic>Neoplasms - therapy</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Oncology, Experimental</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Palliative care</topic><topic>Palliative Care - economics</topic><topic>Palliative Care - methods</topic><topic>Palliative treatment</topic><topic>Rehabilitation Medicine</topic><topic>Republic of Korea</topic><topic>Retrospective Studies</topic><topic>Terminal Care - economics</topic><topic>Terminal Care - methods</topic><topic>Terminal illnesses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jung, Hyun-myung</creatorcontrib><creatorcontrib>Kim, Jinhyun</creatorcontrib><creatorcontrib>Heo, Dae Seog</creatorcontrib><creatorcontrib>Baek, Sun Kyung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection【Remote access available】</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jung, Hyun-myung</au><au>Kim, Jinhyun</au><au>Heo, Dae Seog</au><au>Baek, Sun Kyung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Health economics of a palliative care unit for terminal cancer patients: a retrospective cohort study</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2012-01-01</date><risdate>2012</risdate><volume>20</volume><issue>1</issue><spage>29</spage><epage>37</epage><pages>29-37</pages><issn>0941-4355</issn><eissn>1433-7339</eissn><abstract><![CDATA[Purpose
The objective of this study was to evaluate cost-reduction efficacy of a palliative care unit (PCU) by analyzing medical expenses of terminal cancer patients.
Methods
Hospital bills and medical records of 656 patients who died of cancer from January to December 2007 at one university hospital in Seoul were analyzed.
Results
Of the total 656 patients, 126 died in the PCU. Compared to non-PCU patients, PCU patients were more likely to permit do-not-resuscitate (DNR), visit the emergency room (ER), and receive palliative chemotherapy (
P
< 0.001,
P
= 0.045,
P =
0.002). The non-PCU patients were admitted to the intensive care unit (ICU), used a ventilator, and received hemodialysis more often (
P
< 0.001,
P
< 0.001,
P
< 0.001). Total medical cost per all patients within 6 months of death averaged $27,863. There was a significant difference in medical costs starting at 2 months before death between PCU and non-PCU patients. The medical cost of the PCU group was 32.8% lower 1 month before death and 33.0% lower 2 months before death than the non-PCU group (
P
< 0.001,
P
< 0.001). Patients using PCU services, those with solid cancers, and those with less than a high school education paid lower medical expenses (
P
< 0.05)
Conclusion
Cost savings of the PCU were verified. It was also determined that specific factors were tied to increased medical expenses during the last 6 months of life. If these parameters are controlled properly, additional cost savings, associated with palliative care could be realized.]]></abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>21110045</pmid><doi>10.1007/s00520-010-1047-y</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Supportive care in cancer, 2012-01, Vol.20 (1), p.29-37 |
| issn | 0941-4355 1433-7339 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_906152048 |
| source | Social Science Premium Collection; Springer Nature; Sociology Collection |
| subjects | Adult Aged Analysis Cancer Cancer patients Care and treatment Chemotherapy Cohort Studies Cost Savings Do-not-resuscitate orders Economic aspects Emergency medical services Female Health Care Costs Health care expenditures Health economics Hospitals, University - economics Humans Intensive Care Units - statistics & numerical data Male Medicine Medicine & Public Health Middle Aged Neoplasms - economics Neoplasms - pathology Neoplasms - therapy Nursing Nursing Research Oncology Oncology, Experimental Original Article Pain Medicine Palliative care Palliative Care - economics Palliative Care - methods Palliative treatment Rehabilitation Medicine Republic of Korea Retrospective Studies Terminal Care - economics Terminal Care - methods Terminal illnesses |
| title | Health economics of a palliative care unit for terminal cancer patients: a retrospective cohort study |
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