In Korea, a substantial proportion of long-term care insurance (LTCI) beneficiaries die within 1 year of seeking the benefit. This study was conducted to evaluate the pattern of medical care use and care cost during the last year of life among Korean LTCI beneficiaries between 2009 and 2013 using the national claims data. The National Health Insurance’s Senior (NHIS-Senior) cohort was used for this retrospective study. The participants were LTCI beneficiaries aged 65 or over as of 2008 who died between 2009 and 2013 (N = 30,433). Medical costs during the last year of life were highest for those who used both medical care services and long-term care (LTC) services and increased as death approached. About half of the participants were hospitalized at the time of death. The use of LTC services at the time of death increased from 13.0 to 22.8%, while those who died at home decreased from 34 to 20%. This study suggests that the use of LTC services did not reduce medical costs by substituting unnecessary inpatient hospitalization. Quality of dying should be considered one of the goals of older adult care, and provisions should be made for palliative care at home or LTC facilities.

中文翻译：

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韩国长期护理保险受益人最近一生的护理费用和医疗使用方式：使用国家索赔数据

在韩国，很大一部分长期护理保险（LTCI）受益人在寻求利益的1年内死亡。这项研究的目的是使用国家索赔数据评估2009年至2013年间韩国LTCI受益人在生命的最后一年中的医疗使用模式和护理费用。这项回顾性研究使用了国民健康保险的高级（NHIS-高级）队列。参与者是截至2008年的65岁或以上的LTCI受益人，他们在2009年至2013年之间去世（N= 30,433）。对于那些同时使用医疗服务和长期护理（LTC）服务的人来说，生命的最后一年的医疗费用最高，并且随着死亡的临近而增加。死亡时约有一半的参与者住院。死亡时使用LTC服务的比例从13.0上升到22.8％，而在家中死亡的人的比例从34％下降到20％。这项研究表明，使用LTC服务并不能通过代替不必要的住院治疗来降低医疗费用。垂死的质量应被视为老年人护理的目标之一，并应为在家或LTC设施中的姑息治疗做出规定。