首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Hospice shared-care saved medical expenditure and reduced the likelihood of intensive medical utilization among advanced cancer patients in Taiwan - A nationwide survey
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Hospice shared-care saved medical expenditure and reduced the likelihood of intensive medical utilization among advanced cancer patients in Taiwan - A nationwide survey

机译:一项全国性的调查显示,台湾的临终关怀共享医疗节省了医疗支出,并降低了晚期癌症患者中进行密集医疗利用的可能性

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Purpose: Hospice shared care (HSC) is a new care model that has been adopted to treat inpatient advanced cancer patients in Taiwan since 2005. Our aim was to assess the effect of HSC on medical expenditure and the likelihood of intensive medical utilization by advanced cancer patients. Methods: This is a nationwide retrospective study. HSC was defined as using "Hospice palliative care (HPC) teams to provide consultation and service to advanced cancer patients admitted in the nonhospice care ward." There were 120,481 deaths due to cancer between 2006 and 2008 in Taiwan. Patients receiving HSC were matched by propensity score to patients receiving usual care. Of the 120,481 cancer deaths, 12,137 paired subjects were matched. Medical expenditures for 1 year before death were assessed between groups using a database from the Bureau of National Health Insurance. Paired t and McNemar's tests were applied for comparing the medical expenditure and intensive medical utilization before death between paired groups. Results: Compared to the non-HSC group, subjects receiving HSC had a lower average medical expenditure per person (US$3,939 vs. US$4,664; p<0.001). The HSC group had an adjusted net savings of US$557 (13.3 %; p<0.001) in inpatient medical expenditure per person compared with the non-HSC group. Subjects that received different types of HPC had 15.4-44.9 % less average medical expenditure per person and significantly lower likelihood of intensive medical utilization than those that did not receive HPC. Conclusions: HSC is associated with significant medical expenditure savings and reduced likelihood of intensive medical utilization. All types of HPC are associated with medical expenditure savings.
机译:目的:临终关怀共享护理(HSC)是一种新的护理模式,自2005年以来已在台湾用于治疗住院晚期癌症患者。我们的目的是评估HSC对医疗费用的影响以及晚期癌症进行密集医疗利用的可能性耐心。方法:这是一项全国性的回顾性研究。 HSC被定义为使用“临终关怀姑息治疗(HPC)团队为在非临终关怀病房中收治的晚期癌症患者提供咨询和服务。”在2006年至2008年之间,台湾有120481人死于癌症。接受HSC的患者的倾向得分与接受常规护理的患者相匹配。在120481例癌症死亡中,有12137例配对了受试者。使用国家健康保险局的数据库评估各组之间死亡前一年的医疗费用。配对t和McNemar的检验用于比较配对组之间死亡前的医疗费用和密集医疗利用率。结果:与非HSC组相比,接受HSC的受试者的人均医疗费用较低(3,939美元对4,664美元; p <0.001)。与非HSC组相比,HSC组的人均住院医疗费用调整后净节省为557美元(13.3%; p <0.001)。与未接受HPC的受试者相比,接受不同类型的HPC的受试者的人均医疗费用减少了15.4-44.9%,并且进行密集医疗的可能性大大降低。结论:HSC与节省大量医疗费用和降低密集医疗利用的可能性有关。所有类型的HPC都可以节省医疗费用。

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