RESEARCH ARTICLE The Impact of Hospice Care on Survival and Healthcare Costs for Patients with Lung Cancer: A National Longitudinal Population- Based Study in Taiwan

Background The healthcare costs of cancer care are highest in the last month of life. The effect of hos-pice care on end-of-life (EOL) healthcare costs is not clearly understood. Purpose The purpose of this study was to evaluate the effect of hospice care on survival and health-care costs for lung cancer patients in their final month of life. Methods We adopted Taiwan’s National Health Insurance Research Claims Database to analyze data for 3399 adult lung cancer patients who died in 1997–2011. A logistic regression analy-sis was performed to determine the predictors of high healthcare cost, defined as costs fall-ing above the 90th percentile. Patients who received hospice cares were assigned to a hospice (H) group and those who did not were assigned to a non-hospice (non-H) group. Results The patients in the H group had a longer mean (median) survival time than those in the non