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Cost-Effectiveness Analysis of Home-Based Hospice-Palliative Care for Terminal Cancer Patients
Ye-Seul Kim1, Euna Han2, Jae-Woo Lee1
1Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Journal of Hospice and Palliative Care
|September 7, 2023
Summary
Home-based hospice care is more cost-effective for terminal cancer patients in Korea than inpatient care. Even with doubled costs, home hospice remains affordable, offering better value and quality of life adjustments.
Area of Science:
- Health Economics
- Palliative Care Research
- Oncology Outcomes
Background:
- Terminal cancer patient care in Korea presents significant cost considerations.
- Evaluating the economic impact of different hospice care models is crucial for resource allocation.
Purpose of the Study:
- To compare the cost-effectiveness of inpatient versus home-based hospice-palliative care services for terminal cancer patients in Korea.
- To determine the economic viability of home-based hospice care under various financial scenarios.
Main Methods:
- A decision-analytic Markov model was employed, adopting a healthcare system perspective over a 9-week horizon.
- Transition probabilities were derived from Korean National Cancer Center and Health Insurance Review & Assessment Service data (2017, 2020).
- Quality of Life (QOL) was quantified as quality-adjusted life weeks (QALW), with analysis performed using TreeAge software.
Main Results:
- Home-based hospice care yielded an incremental cost-effectiveness ratio (ICER) of 796,476 KRW/QALW compared to inpatient care.
- The incremental cost was 697,657 KRW with an incremental effectiveness of 0.88 QALW for the home-based group.
- Sensitivity analyses indicated the ICER could increase to 1,626,988 KRW/QALW if home-based costs doubled, but decrease significantly if home death rates doubled.
Conclusions:
- Home-based hospice-palliative care demonstrates greater cost-effectiveness than inpatient services for terminal cancer patients in Korea.
- The affordability of home-based hospice is maintained even with a twofold increase in associated medical expenditures, suggesting its sustainability.
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