Terminal care costs in childhood cancer

To present a conceptualization of health care costs and to describe costs of health care in the terminal phase of childhood cancer. To present an exploratory comparison of the costs of terminal care in the hospital versus home care services, and to discuss the use of cost research in nursing practice.

Telephone interviews were done approximately 16 months after the death of a child to retrospectively ascertain services used, costs to the family, and insurance information. Provider billing and insurance data were subsequently collected. The families were divided into two groups based upon the use of home care or traditional hospital care during the terminal phase.

Home care was less expensive for total costs than hospital care. Home care was more expensive for nonhealth care and indirect costs than hospital care.

Nurses should consider direct health care costs, nondirect health care costs, and indirect costs when assisting family decisions about care. Nurses and families should be aware of potential cost shifting.