An analysis of the costs of terminal care in Japan revealed that the last month of life accounted for almost one-third of the costs incurred by patients during the entire preceding 10 months. In order to reduce the costs of terminal care and raise the level of care provided in the community two groups, an urban group led by Dr. Sato and a rural group led by Dr. Asai, developed innovative approaches for providing community care to terminal cancer (and other) patients. Three case studies illustrate the way the terminal stages of illness are managed under these new approaches. The authors conclude by proposing several reforms to improve the delivery of care to the terminally ill.
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