Medical expenditure and family satisfaction between hospice and general care in terminal cancer patients in Taiwan.
OBJECTIVE
As the number of terminal cancer patients increases, several care models have been adopted to provide better care quality and reduce medical expenditure. This study compared inpatient medical expenditure and family satisfaction in a hospice ward (HW) and general ward (GW) for terminal cancer patients in Taiwan.


METHODS
We enrolled terminal cancer patients who were admitted and died during the same admission period in a tertiary care hospital in Taiwan from January 2003 to December 2005. These patients were allocated into three groups: inpatient care in HW alone; inpatient care in GW alone; and inpatient care in mixed group (initially in GW, then transferred to HW). Inpatient medical expenditure and family satisfaction were compared between the three groups.


RESULTS
A total of 1942 patients were recruited and allocated into HW (n = 292), GW (n = 1511) and mixed (n = 139) groups. The average medical expenditure per person or per inpatient day was lower in the HW than the GW or mixed group. Subjects who had ever been admitted to the intensive care unit or received cardiopulmonary resuscitation in the GW or mixed groups required more expenditure on medical care than that in the HW group. Daily medical expenditure in the HW group also was much lower than that in the GW and mixed groups, based on length of stay and cancer type. The family satisfaction score was significantly higher in the mixed and/or HW group than the GW group.


CONCLUSIONS
For terminal cancer patients, hospice care can improve family satisfaction while reducing medical expenditure in Taiwan.
Lin
Wen-Yuan
WY
Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
Chiu
Tai-Yuan
TY
Hsu
Hua-Shai
HS
Davidson
Lance E
LE
Lin
Tsann
T
Cheng
Kao-Chi
KC
Chiu
Chang-Fang
CF
Li
Chia-Ing
CI
Chiu
Yi-Wen
YW
Lin
Cheng-Chieh
CC
Liu
Chiu-Shong
CS
D000328:Adult; D000368:Aged; D003258:Consumer Behavior; D005190:Family / Q000523:psychology; D005260:Female; D005102:Health Expenditures; D017051:Hospice Care / Q000191:economics*; D006738:Hospices; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics / Q000401:mortality / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010166:Palliative Care / Q000191:economics*; D010362:Patients' Rooms; D011795:Surveys and Questionnaires; D013624:Taiwan