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Differences in physician access patterns to hospice care.

M J Stillman1, K L Syrjala

  • 1Division of Palliative Medicine, Cleveland Clinic Foundation, Ohio 44195, USA.

Journal of Pain and Symptom Management
|March 31, 1999
PubMed
Summary
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Referral timing to hospice care is influenced by health care benefits and patient factors, not solely physician type. Shorter hospice stays correlated with lower caregiver satisfaction.

Area of Science:

  • Health Services Research
  • Palliative Care Medicine
  • Health Economics

Background:

  • Discussions on out-of-hospital health care financing and end-of-life care converge at the intersection of healthcare costs and hospice/palliative medicine viability.
  • Understanding factors influencing hospice referral timing is crucial for both patient care and economic sustainability.

Purpose of the Study:

  • To evaluate factors associated with the timing of referral to hospice care.
  • To assess the relationship between physician referral source and length of stay in hospice.
  • To examine caregiver satisfaction with hospice care based on length of stay.

Main Methods:

  • Analysis of 101 admissions to a Medicare-certified hospice during the last quarter of 1995.
  • Comparison of patient lengths of stay based on referral source (oncologist vs. non-oncologist).

Related Experiment Videos

  • Statistical analysis including chi-squared tests and t-tests to determine significance.

    • Main Results:

    • No significant difference in mean length of stay between oncologist-referred and non-oncologist-referred patients.
    • Patients referred by non-oncologists had longer stays (>30 days) when considering non-cancer diagnoses, older age, and Medicine hospice benefit.
    • Caregivers of patients with shorter hospice stays reported significantly lower satisfaction with care.

    Conclusions:

    • Health care benefits and patient-specific factors, rather than physician preference alone, appear to influence hospice referral timing.
    • Referral patterns differ between oncologists and non-oncologists, particularly for non-cancer patients.
    • Shorter hospice lengths of stay are associated with decreased caregiver satisfaction, highlighting the importance of adequate care duration.