Medical Expenditure and Family Satisfaction Between Hospice and General Care in Terminal Cancer Patients in Taiwan

Lin, Wen-Yuan; Chiu, Tai-Yuan; Hsu, Hua-Shai; Davidson, Lance E.; Lin, Tsann; Cheng, Kao-Chi; Chiu, Chang-Fang; Li, Chia-Ing; Chiu, Yi-Wen; Lin, Cheng-Chieh; Liu, Chiu-Shong

doi:10.1016/S0929-6646(09)60407-1

« Previous Next »Journal of the Formosan Medical Association
Volume 108, Issue 10 , Pages 794-802, October 2009

Medical Expenditure and Family Satisfaction Between Hospice and General Care in Terminal Cancer Patients in Taiwan

Wen-Yuan Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, Taichung, Taiwan
Tai-Yuan Chiu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
Hua-Shai Hsu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
Lance E. Davidson
- St Luke's-Roosevelt Hospital, Columbia University, New York, NY, USA
Tsann Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, Taichung, Taiwan
Kao-Chi Cheng
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
Chang-Fang Chiu
- Division of Hematology/Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
Chia-Ing Li
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
Yi-Wen Chiu
- Preventive Medicine Center, China Medical University Hospital, Taichung, Taiwan
Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, Taichung, Taiwan
- School and Graduate Institute of Health Care Administration, College of Public Health, China Medical University, Taichung, Taiwan
- Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan
Chiu-Shong Liu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, Taichung, Taiwan
- Correspondence to: Dr Chiu-Shong Liu, Department of Family Medicine, China Medical University Hospital, 2 Yuh-Der Road, Taichung 404, Taiwan

Received 28 August 2008; received in revised form 29 April 2009; accepted 5 May 2009.

Background/Purpose

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.