Acute hospital admissions of hospice patients

Research into acute hospital admissions (AHAs) of hospice patients is relatively underdeveloped. The goal of this study, based on the electronic health records (EHR) of a large Midwestern hospice service over a 3-year period, was to identify characteristics of new hospice patients that are associated with an increased risk of later AHAs.

Our study of a large and undifferentiated hospice population revealed several important new findings regarding AHA. We found these previously unreported factors associated with elevated AHA rates: 1) hospice diagnoses of terminal heart and lung disease compared with other diagnoses; and 2) the home care setting compared with the nursing home setting. Moreover, previous studies had not looked in detail at the timing of AHA over the course of hospice care or related the timing of AHA to the reason for AHA.

The future agenda for research on AHA of hospice patients should include studies of large and undifferentiated hospice populations like our own, but designed to capture data on socioeconomic status (SES), religion, race/ethnicity, the details of supportive care in place, and a look at specific factors surrounding individual AHAs.