title: Medical Costs and Healthcare Utilization among Cancer Decedents in the Last Year of Life in 2009.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the cancer care cost during the last year of life of patients in Korea.
  
  
  METHODS
  We studied the breakdown of spending on the components of cancer care. Cancer decedents in 2009 were identified from the Korean Central Cancer Registry and linked with the Korean National Health Insurance Claims Database. The final number of patients included in the study was 70,558.
  
  
  RESULTS
  In 2009, the average cancer care cost during the last year of life was US $15,720. Patients under age 20 spent US $53,890 while those 70 or over spent US $11,801. Those with leukemia incurred the highest costs (US $43,219) while bladder cancer patients spent the least (US $13,155). General costs, drugs other than analgesics, and test fees were relatively high (29.7%, 23.8%, and 20.7% of total medical costs, respectively). Analgesic drugs, rehabilitation, and psychotherapy were still relatively low (4.3%, 0.7%, and 0.1%, respectively). Among the results of multiple regression analysis, few were notable. Age was found to be negatively related to cancer care costs while income level was positively associated. Those classified under distant Surveillance, Epidemiology, and End Results stages of cancer and higher comorbidity level also incurred higher cancer care costs.
  
  
  CONCLUSIONS
  Average cancer care costs varied significantly by patient characteristics. However, the study results suggest an underutilization of support services likely due to lack of alternative accommodations for terminal cancer patients. Further examination of utilization patterns of healthcare resources will help provide tailored evidence for policymakers in efforts to reduce the burdens of cancer care.
authors.affiliation: National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Inuk
authors.initials: I
authors.lastname: Hwang
authors.affiliation: Department of Family Medicine and Health Promotion Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea ; Cancer Survivorship Clinic, Seoul National University Cancer Hospital, Seoul National University College of Medicine, Seoul, Koarea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Shin
authors.affiliation: National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Kyoung Hee
authors.initials: KH
authors.lastname: Kang
authors.affiliation: National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Hyung Kook
authors.initials: HK
authors.lastname: Yang
authors.affiliation: Chungbuk Regional Cardiocerebrovascular Center, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Graduate School of Health Science Business Convergence, Chungbuk National University, Cheongju, Korea ; Department of Preventive Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Jong-Hyock
authors.initials: JH
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs; D006291:Health Policy; D006801:Humans; D007348:Insurance, Health; D007938:Leukemia / Q000191:economics; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D013727:Terminal Care / Q000191:economics; D001749:Urinary Bladder Neoplasms / Q000191:economics; D055815:Young Adult
keywords: Health care costs; Neoplasms; Terminal care