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Has Hospice Use Changed? 2000-2010 Utilization Patterns.

Melissa D Aldridge1, Maureen Canavan, Emily Cherlin

  • 1*Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York †James J. Peters VA Medical Center, Bronx, NY ‡Department of Health Policy and Management, Yale School of Public Health, New Haven, CT.

Medical Care
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Summary
This summary is machine-generated.

Medicare hospice use patterns show over half of patients have very short or long stays, or disenroll before death. This highlights a need for better hospice referral timing to maximize patient benefits.

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Area of Science:

  • Gerontology
  • Palliative Care
  • Health Services Research

Background:

  • Hospice utilization has significantly increased among a diverse patient population over the past decade.
  • Understanding evolving patterns in hospice use is crucial for quality end-of-life care.

Purpose of the Study:

  • To analyze Medicare hospice user characteristics in 2000 and 2010.
  • To determine the prevalence of very short (≤1 week), very long (>6 months) hospice enrollment, and hospice disenrollment.
  • To examine how these utilization patterns have changed over time and varied by patient and hospice factors.

Main Methods:

  • Cross-sectional analysis of US Medicare hospice claims data.
  • Inclusion of all Medicare Hospice Benefit enrollees in 2000 (N=529,573) and 2010 (N=1,150,194).

Main Results:

  • In 2010, 53.4% of Medicare decedents using hospice had very short (32.4%), very long (13.9%) enrollment, or disenrolled (10.6%), an increase from 2000.
  • Patients with non-cancer diagnoses, the fastest-growing group, were twice as likely as cancer patients to experience very short/long enrollment or disenrollment.
  • Significant shifts in hospice utilization patterns were observed between 2000 and 2010.

Conclusions:

  • A substantial proportion of hospice users experience suboptimal enrollment durations or disenrollment.
  • Interventions targeting timely and appropriate hospice referrals are needed.
  • Improving referral timing can ensure patients and families receive the full benefits of hospice care.