Strategies for Development of Hospice Reimbursement

Article information

J Korean Med Assoc. 2008;51(6):517-523
Publication date (electronic) : 2008 June 30
doi : https://doi.org/10.5124/jkma.2008.51.6.517
1Department of Family Medicine, Korea University College of Medicine, Korea. bloves@naver.com
2Department of Oncology, Korea University College of Medicine, Korea. kjs6651@kumc.or.kr

Abstract

In the last few moments of life before death, a more adequate health care system must be established in order for suffering patients to have their dignity respected. To this point, Korea's health care system does not possess additional health insurance reimbursement covering hospice care. Until recently, the existing fee for service system consists of an informal hospice care service that has been developed and supplied. Due to society's increasing expectation of hospice reimbursement in regard to development and in reality, progression is currently being undertaken which we have welcomed. However, there has been a tendency for over expectation in financial reduction by hospice reimbursement introduction in which there were evidence from cases in other nations. In practice, supplementation of per diem type of hospice coverage will be the mainstream and fee for service in some areas must be explored in order to compensate for the negative aspects of per diem type of hospice coverage.

References

1. Stjernswärd J, Foley KM, Ferris FD. The public health strategy for palliative care. J Pain Symptom Manage 2007. 33486–493.
2. Emanuel E. Cost savings at the end of life: what do the data show? JAMA 1996. 2751907–1914.
3. Lo JC. The impact of hospices on health care expenditures-the case of Taiwan. Soc Sci Med 2002. 54981–991.
4. Hospice and palliative care facts and figures 2005. Hospice Information Accessed on March 24, 2008. Available from.http://www.hospiceinformation.info/uploads/documents/hospice_&_palliative_care_facts_&_figures_2005.pdf.
5. Connor SR, Tecca M, LundPerson J, Teno J. Measuring hospice care: the National Hospice and Palliative Care Organization national hospice data set. J Pain Symptom Manage 2004. 28316–328.
6. Swiger H. "Hospice care and the institutional barriers to its success", A paper commissioned by the National Hospice and Palliative Care Organization's Public Policy Committee 2002. 02.
7. Liu CN, Yang MC. National health insurance expenditure for adult beneficiaries in Taiwan in their last year of life. J Formos Med Assoc 2002. 101552–559.
8. Ida E, Miyachi M, Uemura M, Osakama M, Tajitsu T. Current status of hospice cancer deaths both in-unit and at home (1995~2000), and prospects of home care services in Japan. Palliat Med 2002. 16179–184.
9. Emanuel EJ, Ash A, Yu W, Gazelle G, Levinsky NG, Saynina O, McClellan M, Moskowitz M. Managed care, hospice use, site of death, and medical expenditures in the last year of life. Arch Intern Med 2002. 1621722–1728.
10. Tang Siew Tzuh, Chen Mei-Ling, Huang Ean-Wen, Koong Shin-Lan, Lin Gia Li, Hsiao Shu-Chun. Hospice utilization in taiwan by cancer patients who died between 2000 and 2004. J Pain Symptom Manage 2007. 33446–453.
11. Miyashita M, Sanjo M, Morita T, Hirai K, Kizawa Y, Shima Y, Shimoyama N, Tsuneto S, Hiraga K, Sato K, Uchitomi Y. Barriers to providing palliative care and priorities for future actions to advance palliative care in Japan: a nationwide expert opinion survey. J Palliat Med 2007. 10390–399.
12. Ryu Hosihn. Current status of costs and utilizations of hospital based home health nursing care in Korea. J Korean Acad Nurs 2006. 361164–1174.

Article information Continued

Table 1

National hospice reimbursement rates 2007

Table 1

*Care visits (RN, home health aid, social worker), Home respite care, Interdisciplinary group, Drugs, Medical supplies, Durable medical equipment (DME), Outpatient hospital services (i.e., palliative chemotherapy/radiation)