目標：癌症為國人近年主要死因的第一位。癌末病患除了接受一般急救照護外，另一種照護的選擇為安寧療護。文獻顯示國外安寧療護能降低醫療費用，但國內少有以健保資料庫來分析安寧療護的使用情形。方法：以健保資料庫資料比較癌末病患安寧與非安寧療護之住院天數；並經調整病患使用安寧療護的機率 (propensity score，由複邏輯斯迴歸估計) 將選擇兩照護型態隨機化後，進一步比較兩照護型態之平均醫療費用。結果：安寧與非安寧療護的平均住院天數分別為15.23天與23.77天，無論何種照護型態病患有接受手術治療會有較高的平均住院天數、肝癌則比其他疾病有較低的平均住院天數；安寧療護病患選擇區域醫院比其他醫院等級有較高的平均住院天數。安寧與非安寧療護之醫療費用比較中，經propensity score方法調整成隨機化後，安寧療護估計可以降低約四萬至二十二萬元的住院醫療費用。結論：癌末病患使用安寧療護估計可降低平均住院醫療費用，但居家安寧療護及其他養護機構照顧並未考量，建議未來衛生主管機關能夠進一步探討並研究安寧療護的品質及存活。

Objectives: Cancer has been the leading cause of death in Taiwan for years. In addition to curative treatments, patients with cancer can choose hospice care as a medical option. Studies indicate that hospice care could reduce medical expenditures in foreign countries, but little research has been done related to hospice care in Taiwan by using National Health Insurance Databases (NHID).Methods: Length-of-stay was compared between hospice and non-hospice cancer patients by using the NHID. After adjusting for each patient’s probability of hospice care (i.e., the propensity score, as estimated by multiple logistic regression) for randomization, average medical expenditures of two care patterns were further compared.Results: The length-of-stay of hospice and non-hospice care was 15.23 and 23.77 days, respectively. Those who underwent surgery tended to have a longer length-of-stay and those who had liver cancer tended to have a shorter length-of-stay. However, hospice patients who chose to stay in a regional hospital tended to have longer length-of-stay. The medical expenditure of hospice care was estimated to be lower, by approximately NT 40,000-220,000 dollars as compared to non-hospice care, after adjustment of propensity score methods.Conclusions: The average medical expenditure was estimated to be lower when end-of-life hospitalized cancer patients choose to have hospice as their care pattern, but home hospice and other care centers were not considered. Further research is suggested to investigate these issues and the quality and survival of hospice care in the future.