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
Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju, Korea.
World J Mens Health. 2021 Jan;39(1):158-167. 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.
本研究旨在评估韩国前列腺癌患者在生命最后一年的临终资源利用情况及费用。
本研究使用了韩国国民健康保险服务的国家健康信息数据库（NHIS - 2017 - 4 - 031）。收集了2002年至2015年韩国国民健康保险系统的医疗理赔数据。在83173例前列腺癌患者中，排除1082例在生命最后一年从未申请理赔的患者后，纳入18419例患者。
2006年至2015年，前列腺癌死亡患者总数增加了3.2倍。无论生存时间长短，生命最后一年的平均护理费用在10年期间有所增加，从14420000韩元增至20300000韩元。除镇痛药外，主要治疗和药物的费用相对较高。放射学检查、阿片类药物、疼痛控制和康复费用相对较低。多元回归分析确定年龄和居住在农村地区与前列腺癌护理费用呈负相关，而收入水平和更多的合并症与费用呈正相关。
前列腺癌患者生命最后一年的护理支出因患者特征而异。平均费用逐年增加。然而，结果表明支持服务利用不足，可能是由于晚期前列腺癌患者缺乏替代住宿。进一步研究医疗资源利用模式将使政策制定者能够采取更好的方法来减轻前列腺癌护理负担。
