Estimating the Costs of End-of-Life Care in Patients With Advanced Cancer From the Perspective of an Insurance Organization: A Cross-Sectional Study in Iran

Cancers are significant medical conditions that contribute to the rising costs of healthcare systems and chronic diseases. This study aimed to estimate the average costs of medical services provided to patients with advanced cancers at the end of life (EOL). We analyzed data from the Sata insurance claim database and the Health Information System of Baqiyatallah hospital in Iran. The study included all adult decedents who had advanced cancer without comorbidities, died between March 2020 and September 2020, and had a history of hospitalization in the hospital. We calculated the average total cost of healthcare services per patient during the EOL period, including both cancer-related and noncancer-related costs. A total of 220 patients met the inclusion criteria. The average duration of the EOL period for these patients was 178 days, with an average total cost of $8278 (SD $5698) for men and $9396 (SD $6593) for women. Cancer-related costs accounted for 64.42% of the total costs, including inpatient and outpatient services. Among these costs, hospitalization was the primary cost driver and had the greatest impact on EOL costs. This observation was supported by the multiple linear regression model, which suggested that hospitalization in the final days of life could potentially drive costs in these patients. Notably, no specialized palliative care was provided to the patients included in this study. The results demonstrate that there is a significant rise in costs of care in patients receiving routine cancer care rather than optimized EOL care. •Patients who die in hospitals incur significantly higher costs than those who die in other settings, such as at home or in a hospice.•This raises questions about the preference for hospital care during this period, given that many patients may prefer to die in a more comfortable and familiar setting.•The study highlights the need for effective cost-management strategies to reduce the financial burden of end-of-life cancer care.•The authors urge decision-makers, especially in less-developed or developing countries, to explore home-based and palliative care options, given that these can improve the quality of care while reducing costs.•The study also underscores the need for informed decision-making regarding resource allocation.