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Hospice use before death: variability across cancer diagnoses
Beth A Virnig1, A Marshall McBean, Sara Kind
1Division of Health Services Research and Policy, University of Minnesota School of Public Health, Minneapolis, Minnesota 55455, USA. virni001@tc.umn.edu
Medical Care
|December 19, 2001
Summary
Hospice use before death shows remarkable consistency across various cancer diagnoses and demographic groups. This suggests improved ability to predict prognosis and patient preferences for end-stage cancer care.
Area of Science:
- Oncology
- Palliative Care
- Health Services Research
Background:
- Limited data exists on hospice utilization patterns among cancer patients nearing end-of-life.
- Understanding these patterns is crucial for improving palliative care access and quality.
Purpose of the Study:
- To investigate variations in hospice use rates based on specific cancer types.
- To analyze hospice use differences across age, sex, and racial demographics.
- To examine the length of stay in hospice for cancer patients.
Main Methods:
- Utilized Medicare hospice administrative (claims) data for elderly beneficiaries.
- Obtained cause-specific mortality data from the National Center for Health Statistics.
- Calculated hospice use rates via direct standardization (age, sex, race) and median length of stay.
Main Results:
- Hospice use rates per 100 deaths ranged narrowly from 42.0 (breast cancer) to 48.1 (pancreatic cancer).
- Black beneficiaries utilized hospice services at 82% the rate of non-black beneficiaries.
- Men and women exhibited similar hospice entry rates; median hospice length of stay was 21-27 days.
Conclusions:
- Observed significant consistency in hospice use rates across diverse cancer diagnoses.
- This consistency surpasses expectations given varying cancer prognoses.
- Findings imply enhanced predictability of prognosis and patient preferences for hospice care among end-stage cancer patients.