Can hospices predict which patients will die within six months?

Area of Science:

• Palliative Care
• Geriatric Medicine
• Health Services Research

Background:

• Hospice enrollment criteria often rely on prognosis.
• Accurate prediction of 6-month mortality is crucial for determining hospice eligibility and resource allocation.

Purpose of the Study:

• To identify predictors of 6-month mortality among hospice enrollees.
• To assess the feasibility of predicting which patients may not meet continued hospice eligibility criteria.

Main Methods:

• Retrospective cohort study utilizing electronic health records.
• Analysis of 126,620 patients admitted to 10 hospices within the CHOICE network.
• Multivariable logistic regression to identify independent predictors of 6-month mortality.

Main Results:

• 93.6% of patients died within 6 months of hospice admission.
• Five characteristics independently predicted 6-month mortality, including age and sex.
• Specific subgroups, such as stroke patients with a Palliative Performance Scale score of 50, showed a lower predicted 6-month mortality (39.4%), though confidence intervals were wide.

Conclusions:

• Hospice providers can utilize specific patient characteristics to identify individuals at lower risk for 6-month mortality.
• These identified patients may warrant closer monitoring for disease progression to ensure continued eligibility for hospice services.