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Predictors of withdrawal from hospice
D J Casarett1, M E Marenberg, J H Karlawish
1Philadelphia Veterans Affairs Medical Center, University of Pennsylvania, Department of Medicine, Division of Geriatrics, Philadelphia, Pennsylvania, USA. casarett@mail.med.upenn.edu
Journal of Palliative Medicine
|January 19, 2002
Summary
Many eligible patients withdraw from hospice care. Factors like being male, younger, and lacking certain medical interventions predict withdrawal, highlighting a need for further research into patient preferences.
Area of Science:
- Palliative Care
- End-of-Life Care Research
Background:
- Hospice care aims to support terminally ill patients.
- A notable percentage of medically eligible patients withdraw from hospice services.
- Factors influencing this withdrawal remain largely undescribed.
Purpose of the Study:
- To identify predictors of hospice withdrawal among eligible patients.
- To understand characteristics associated with patients leaving hospice prematurely.
Main Methods:
- Retrospective cohort study design.
- Analysis of 1,691 patients in an urban, nonprofit hospice program (1997-1999).
- Examined time to discharge for eligible patients.
Main Results:
- 15% of eligible patients were discharged from hospice.
- Predictors of withdrawal included being male, unmarried, younger than 65, non-cancer diagnosis.
- Lack of a do-not-resuscitate order and absence of symptoms requiring intervention also predicted withdrawal.
Conclusions:
- A significant proportion of hospice patients withdraw despite meeting eligibility criteria.
- Further investigation is required to understand the reasons for withdrawal.
- Research should explore if withdrawal aligns with patient preferences.
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