Estimatied health care costs in terminal care for cancer patients using real-world data

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K23215
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: National Institute of Public Health
• Principal Investigator: Yuki Takumoto 国立保健医療科学院, その他部局等, 研究員 (10880172)
• Project Period (FY): 2020-09-11 – 2023-03-31
• Keywords: 医療費推計 / がん / 終末期医療 / 死亡 / ナショナルデータベース

Outline of Final Research Achievements

In this study, we used the Sampling dataset of National data to estimate medical costs immediately before death, mainly among cancer patients. Specifically, the study mainly included deceased patients who were not undergoing active treatment for cancer, and the analysis period was April and October in 2015-2019 for a total of 10 months. Direct medical costs were aggregated to estimate mainly weekly medical costs.
The analysis identified 7,296 cancer deaths. This population consisted of 43.5% aged 80-89 years, 59.6% were male, and the most common cancer tumor was lung cancer at 18.0%. The median weekly medical cost (Q1-Q3) immediately before death was 180,429 yen (137,935 yen-291,305 yen).

Free Research Field

医療経済評価

Academic Significance and Societal Importance of the Research Achievements

従来の抗癌剤の費用効果分析では、一般的に抗癌剤を中止した患者に一律のケアが実施される仮定で分析が行われることも少なくない。一方で、実臨床では治療及び終末期ケアの体制を患者の疾患状態やニーズに準じて選択しており、特に死亡直前の状況では通常のケアとは大きく異なる可能性がある。これは従来の費用効果分析における終末期ケアの仮定と乖離しているが、終末期ケアの医療費を推計した代表性の高いエビデンスは少ない。このGAPを解決するために、本研究では国内最大のレセプト情報・特定健診等情報データベースを活用することで、癌患者における終末期医療費を推計できたと考えている。