Differences Between Inpatient Hospice Care and In-hospital Nonhospice Care for Cancer Patients

Background: Decisions for the type of palliative care are affected by multiple factors. Currently, most patients die without palliative care, and hospice patients receive only a brief period of services before death. Objective: This study aimed to compare palliative terminal cancer care in inpatient hospice and nonhospice care units in Taiwan for type of cancer, cost, stay, and selected demographic and clinical characteristics. Methods: A retrospective study of terminally ill cancer patients hospitalized in a hospice unit (410 patients) or a general cancer ward (3005 patients) in a hospital in Taiwan was conducted. Patient demographic information, length of stay, cost of treatments, interventions and diagnostic testing, and types of cancer were analyzed. The factors associated with hospice care were revealed by multivariate stepwise regression. Results: In the hospice group, the total cost was lower; there were more female, and more head, neck, and lung tumor patients. The most tumors in nonhospice group are hepatomas. The patients in hospice group received fewer interventions and had a long hospital stay (914 days) before death; however, most of them were discharged from the hospital due to death. Conclusions: Utilization of hospice care varies by sex and type of cancer. Compared with the nonhospice service, hospice care needs a lower total cost and fewer interventions. Implications for Practice: Hospice care in Taiwan should provide more services and facilities specific for sex (female) and tumors (head and neck).