생의 말기 재가 환자의 통합지원에 대한 비용편익 분석

Cost-Benefit Analysis of Integrated Support for the End of Life

Purpose: This study conducted a cost-benefit analysis of an integrated support operation model for end-of-life care services for chronically ill patients at home to provide a basis for local governments to provide integrated care support. Methods: The study population included patients registered in the family medicine department of a large hospital in Seoul and receiving home care services. The costs and benefits were estimated for households using the community integrated support service and those using existing home care services. The service period was three months, and the number and costs of outpatient and pharmacy visits were examined before and after the service period to estimate the additional costs and benefits of using the Community Integrated Support Service. Results: When the integrated support center was used by one doctor, one nurse, and one case manager to care for 32 homebound patients, the total cost was KRW 9,357,972 more than the home care center under the same conditions; the net benefit was KRW 16,764,767, which was 2.79 times higher than the cost. In the sensitivity analysis, even if the discount rate of the benefit was reduced to 21% and the cost was increased by 140%, the net benefit was a benefit-cost ratio of 1.58. Conclusion: The results suggest that an integrated community medical, health, and social care service model should be developed and implemented in end-of-life home care. Especially in the case of medical care, it is necessary to consider its costs.