Using a Case-Mix System to Identify Long-Term Care Needs Among Discharged Cancer Patients: A Retrospective Study from Taiwan

Background Advances in cancer detection and treatment have substantially improved survival, resulting in a growing population of cancer survivors with complex long-term care (LTC) needs. However, systematic approaches to identifying and stratifying post-discharge LTC requirements within health service settings remain limited. This study evaluated LTC needs among discharged cancer patients using a Case-Mix System (CMS) and examined its utility for discharge planning and service allocation. Methods We conducted a retrospective descriptive study of adult cancer patients who received structured discharge planning at a tertiary hospital in Taiwan between January and December 2024. Discharge outcomes, applications for government-funded LTC services, and service utilization patterns were analyzed. Functional status and disability severity were classified using the CMS. Descriptive statistics and chi-square tests were applied to examine LTC utilization across CMS disability levels. Results Among 207 discharged cancer patients, 68.1% returned home, 12.6% were transferred to LTC facilities, and 18.8% died during hospitalization. Of the 167 patients discharged to home or care facilities, 44.9% applied for government-funded LTC services. Based on CMS classification, 25.3% had mild disability, 48.0% moderate disability, and 26.7% severe disability. Distinct service utilization patterns were observed across disability levels. Patients with mild disability primarily required basic home-care services, whereas those with moderate disability demonstrated significantly higher use of combined home-care and respite services. Patients with severe disability showed the greatest reliance on respite care, reflecting substantial caregiver burden. Conclusions CMS-based assessment at hospital discharge effectively identifies heterogeneous LTC needs among cancer patients and supports stratified care planning. Integrating CMS into discharge planning may facilitate timely LTC referrals, optimize resource allocation, and reduce caregiver burden, offering important implications for health service delivery and long-term care policy.