title: Effects of Per-diem payment on the duration of hospitalization and medical expenses according to the palliative care demonstration project in Korea.
abstract: OBJECTIVE
  The aim of this study was to examine the impacts of a government-directed palliative care demonstration (PCD) project, Per-diem Payment System (PDPS), on length of stay (LOS), hospital costs, resource usage and healthcare quality during the searched period from January in 2009 to December in 2010.
  
  
  METHODS
  A retrospective claim data review.
  
  
  METHODS
  Individuals who had been eligible for the palliative care payment policy, PDPS, during 2 years (from 2009 to 2010) were assigned to the case group including seven hospitals (n = 3117). Those (seven hospitals) who were not come eligible for the palliative care payment policy were assigned to the control group (n = 2347) with fee for service. The data used in this study were electronically submitted requests of payment to the Health Insurance Review Agency during the period January 2009 to December 2010.
  
  
  RESULTS
  After the PCD project, the length of stay for palliative patients with cancer diseases decreased by 2.56% (β = -0.026; p-value = 0.0001) among patients hospitalized in a PCD project compared with patients hospitalized in seven hospitals that was not designed as a PCD project. Compared with costs before the PCD project, costs decreased by 0.76% (β = 0.013; p-value = 0.0001).
  
  
  CONCLUSIONS
  We provided evidence regarding the change in the societal burden due to palliative care. Although there was a reduction of direct medical costs reported in limited number of hospitals, in the long term, we can anticipate an expanding impact on medical costs in all palliative hospitals. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Seoul, Korea.
authors.forename: J Y
authors.initials: JY
authors.lastname: Shin
authors.affiliation: Seoul, Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Yoon
authors.affiliation: Seoul, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Ahn
authors.affiliation: Seoul, Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Yun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005102:Health Expenditures; D006291:Health Policy; D006295:Health Resources / Q000706:statistics & numerical data; D006302:Health Services Research; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000191:economics*; D011787:Quality of Health Care; D012051:Reimbursement Mechanisms; D056910:Republic of Korea; D012189:Retrospective Studies
keywords: cancer diseases; evaluation methodology; health payment system; health policy; health services research