Cost-Effectiveness Analysis of Home-Based Hospice-Palliative Care for Terminal Cancer Patients
10.14475/jhpc.2022.25.2.76
- Author:
Ye-seul KIM
1
;
Euna HAN
;
Jae-woo LEE
;
Hee-Taik KANG
Author Information
1. Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
- Publication Type:Original Article
- From:Korean Journal of Hospice and Palliative Care
2022;25(2):76-84
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:We compared cost-effectiveness parameters between inpatient and homebased hospice-palliative care services for terminal cancer patients in Korea.
Methods:A decision-analytic Markov model was used to compare the cost-effectiveness of hospicepalliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW).Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results.
Results:Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled.
Conclusion:Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.
