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Hospice use among patients with heart failure
Kevin T Bain1, Terri L Maxwell, Scott A Strassels
1Department of Quality Outcomes, excelleRx, Inc., 1601 Cherry Street, Philadelphia, PA 19102, USA. kbain@excellerx.com
American Heart Journal
|June 23, 2009
Summary
Hospice care is underused for heart failure patients. While short-term use is similar to cancer patients, heart failure patients are more likely to use hospice long-term and be discharged alive.
Area of Science:
- Palliative Care
- Gerontology
- Cardiology
Background:
- Hospice care is vital for end-of-life management in heart failure (HF) patients.
- Current hospice utilization for HF patients is suboptimal and not well-characterized.
- Understanding hospice use patterns is crucial for improving patient care.
Purpose of the Study:
- To compare hospice utilization between heart failure (HF) and cancer patients.
- To identify characteristics of HF patients utilizing hospice care.
- To explore potential improvements in hospice access for HF patients.
Main Methods:
- Retrospective analysis of hospice use among 11,754 HF patients and 31,228 cancer patients.
- Data collected from patients discharged or deceased in hospice between January 1, 2004, and June 30, 2005.
- Comparison of hospice duration, discharge status, and demographic factors.
Main Results:
- Similar short-term hospice use (<7 days) for HF and cancer patients (31.7% vs 30.8%).
- HF patients were significantly more likely to receive long-term hospice care (>6 months) (7.6% vs 1.1%).
- HF patients had higher rates of alive discharge from hospice (19.0% vs 11.3%), particularly African Americans and those on HF medications.
Conclusions:
- HF patients exhibit distinct hospice utilization patterns compared to cancer patients.
- Findings suggest potential barriers or opportunities within the Medicare Hospice Benefit for HF patients.
- Further research is needed on patient and clinician perspectives to optimize hospice referrals for HF.
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