Healthcare utilization among children and young people with life-limiting conditions: Exploring palliative care needs using National Health Insurance claims data

Abstract

Paediatric palliative care (PPC) is regarded as standard care for children and young people (CYP) with life-limiting conditions (LLCs). There is a lack of knowledge about the rate of CYP with LLCs, hampering the development of PPC. This retrospective study aimed to examine population-based statistics of South Korean CYP with LLCs and the pattern of healthcare use and costs in their last year of life, analysing the National Health Insurance Service claims database for the period 2013-2015. In 2015, the number of CYP (≤24 years old) living with LLCs was 133,177, with those who died accounting for 1,032. Prevalence of LLC and mortality rate per 100,000 were highest among under-1-age group (2,151.7 and 82.7, respectively). In the last year of life, 91.8% of deceased CYP with LLCs were hospitalized at least once and the average length of stay was 101.2 days (standard deviation = 104.1). Deceased CYP with cancer spent more on healthcare than non-cancer CYP (64,266 vs. 40,694 US dollar, p < 0.001). The average relevance index for CYP death related to LLCs was 55.9%. Our results provide baseline information on healthcare utilization and expenditure among CYP with LLCs, which is crucial data for designing evidence-based PPC policy and services.

Figure 1

Relevance indices (RI) for deceased children and young people with life-limiting conditions between 2013 and 2015 and specialized public medical centres for children in Korea. This map was modified from https://commons.wikimedia.org/wiki/File:Largest_religion_by_province_in_South_Korea.svg using Adobe Illustrator CC ver. 24.0.1 (https://www.adobe.com/products/illustrator.html).