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Health Serv Res. 1985 October; 20(4): 407–422.
PMCID: PMC1068891

Cost savings in hospice: final results of the National Hospice Study.


Medicare inpatient and home care costs over the last year of life of terminal cancer patients served in two types of hospices and in conventional care (CC) were compared as a part of the National Hospice Study (NHS). Both home care (HC) and hospital-based (HB) hospice patients had lower costs in the last month of life than did CC patients. HC patients substituted home care for inpatient care, yielding cost savings for lengths of hospice stay of up to 1 year. Although HB patients added home care to relatively high levels of inpatient care, their ancillary costs per inpatient day were significantly lower than those of CC patients. Thus, HB costs over the last year of life were also somewhat less than those of CC. The size of the savings associated with hospice care is sensitive to the type of hospice and the length of stay distribution of patients served; patients served longer have significantly higher costs in the last year of life.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Amado A, Cronk BA, Mileo R. Cost of terminal care: home hospice vs hospital. Nurs Outlook. 1979 Aug;27(8):522–526. [PubMed]
  • Spector WD, Mor V. Utilization and charges for terminal cancer patients in Rhode Island. Inquiry. 1984 Winter;21(4):328–337. [PubMed]
  • Birnbaum HG, Kidder D. What does hospice cost? Am J Public Health. 1984 Jul;74(7):689–697. [PubMed]
  • Mor V, Birnbaum H. Medicare legislation for hospice care: implications of national hospice study data. Health Aff (Millwood) 1983 Summer;2(2):80–90. [PubMed]
  • Buckingham RW, Lupu D. A comparative study of hospice services in the United States. Am J Public Health. 1982 May;72(5):455–463. [PubMed]
  • Greer DS, Mor V, Sherwood S, Morris JN, Birnbaum H. National hospice study analysis plan. J Chronic Dis. 1983;36(11):737–780. [PubMed]
  • Long SH, Gibbs JO, Crozier JP, Cooper DI, Jr, Newman JF, Jr, Larsen AM. Medical expenditures of terminal cancer patients during the last year of life. Inquiry. 1984 Winter;21(4):315–327. [PubMed]
  • Finkler SA. The distinction between cost and charges. Ann Intern Med. 1982 Jan;96(1):102–109. [PubMed]

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