Health services utilization and costs of care in terminal cancer: implications for hospice programs

This study examines utilization of health services and costs of care for cancer patients during the last 6 months of life broken down into 3 time periods, and the relationship with costs of patient characteristics and home care/home hospice use. The data were derived from a retrospective study of a random sample of 133 adult cancer deaths in Monroe County. Data sources included review of medical records, including hospital billing records, and interviews with physicians and surviving relatives. Sixty five patients (49%) used home care services; their total costs of care were somewhat higher than those of non-users even after controlling for age, marital status and length of the terminal care period. The implications of the upcoming hospice legislation are discussed in the light of these results.