Public insurance costs of end-of-life care in hospice residential facilities in Japan: an exploratory comparison with palliative care units.

Expanding non-hospital end-of-life care and clarifying associated cost structures remain major challenges in Japan. This exploratory study examined public insurance costs for patients with cancer receiving end-of-life care in hospice residential facilities (HRFs). Retrospective data and supplementary estimations for eight patients showed that the mean daily costs were JPY 32635 during the month before death and JPY 38642 during the month of death. In comparison, the national reimbursement rates for palliative care units are JPY 51350 per day for Days 1-30 and JPY 45820 per day for Days 31-60. These findings suggest that public insurance expenditures in HRFs may be lower than the benchmark reimbursement level for palliative care units. However, comparisons should be interpreted cautiously because HRFs rely on multiple home-visit services and exclude non-medical expenses, including housing and utility costs.