Trends in End-of-Life Resource Utilization and Costs among Prostate Cancer Patients from 2006 to 2015: A Nationwide Population-Based Study

• Published in: The world journal of men's health Vol. 39; no. 1; pp. 158 - 167
• Main Authors: Ha, Yun Sok, Kim, So Young, Chung, Jae Il, Choi, Hoon, Kim, Jae Heon, Yu, Ho Song, Cho, In Chang, Kim, Hyung Joon, Chung, Hyun Chul, Koh, Jun Sung, Lee, Ji Youl, Park, Dong Jin, Kim, Hyun Tae, Yoo, Eun Sang, Kwon, Tae Gyun, Min, Kyungchan, Kim, Wun Jae, Yun, Seok Joong, Park, Jong Hyock
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society for Sexual Medicine and Andrology 01.01.2021; 대한남성과학회
• Subjects: Age; Androgens; Cancer therapies; Comorbidity; Cost estimates; Emergency medical care; Expenditures; health care costs; Health care policy; healthcare utilization; Industrialized nations; Laparoscopy; Medical diagnosis; National health insurance; Neighborhoods; Original; Palliative care; Patients; Population-based studies; Prostate cancer; prostatic neoplasms; Rural areas; Sociodemographics; terminal care; Trends; 비뇨기과학; United States > US; Terminal care; Health care costs; Prostatic neoplasms; Healthcare utilization
• ISSN: 2287-4208; 2287-4690
• DOI: 10.5534/WJMH.200113

The purpose of this study was to evaluate end-of-life resource utilization and costs for prostate cancer patients during the last year of life in Korea. The study used the National Health Information Database (NHIS-2017-4-031) of the Korean National Health Insurance Service. Healthcare claim data for the years 2002 through 2015 were collected from the Korean National Health Insurance System. Among 83,173 prostate cancer patients, we enrolled 18,419 after excluding 1,082 who never claimed for the last year of life. From 2006 to 2015, there was a 3.2-fold increase the total number of prostate cancer decedents. The average cost of care during the last year of life increased over the 10-year period, from 14,420,000 Korean won to 20,300,000 Korean won, regardless of survival time. The cost of major treatments and medications, other than analgesics, was relatively high. Radiologic tests, opioids, pain control, and rehabilitation costs were relatively low. Multiple regression analysis identified age and living in rural area as negatively associated with prostate cancer care costs, whereas income level and a higher number of comorbidities were positively associated. Expenditure of prostate cancer care during the last year of life varied according to patient characteristics. Average costs increased every year. However, the results suggest underutilization of support services, likely due to lack of alternative accommodation for terminal prostate cancer patients. Further examination of patterns of utilization of healthcare resources will allow policymakers to take a better approach to reducing the burden of prostate cancer care.