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Related Experiment Video

Updated: Dec 23, 2025

Generation of Comprehensive Thoracic Oncology Database - Tool for Translational Research
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Short Hospice Length of Service in a Comprehensive Cancer Center.

Ramy Sedhom1, Arjun Gupta1, Thomas J Smith1

  • 1Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA.

Journal of Palliative Medicine
|April 18, 2020
PubMed
Summary

Peer comparison feedback did not improve hospice length of service (LOS) for cancer patients, with short hospice LOS remaining a quality concern. Further behavioral interventions are needed to enhance end-of-life care.

Keywords:
audit-and-feedbackbehavioral economicsend-of-life cancer carehospicenudge

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Area of Science:

  • Oncology
  • Palliative Care
  • Health Services Research

Background:

  • Hospice care benefits for advanced cancer patients are recognized.
  • Short hospice length of service (LOS) indicates suboptimal care quality and patient/family dissatisfaction.
  • Behavioral science interventions may improve hospice utilization.

Purpose of the Study:

  • To evaluate the impact of peer comparison feedback on short hospice LOS rates among cancer patients.
  • To assess changes in hospice enrollment and LOS following an intervention at a comprehensive cancer center.

Main Methods:

  • A pre-post design study was implemented at an urban, academic, comprehensive cancer center.
  • Sixty oncologists received a peer-comparison feedback intervention using individual hospice data.
  • Key metrics included hospice enrollment rate, median hospice LOS, and percentage of short hospice LOS (≤7 days).

Main Results:

  • Post-intervention, hospice enrollment increased, but median hospice LOS decreased from 14.5 to 9 days.
  • The percentage of patients with short hospice LOS (≤7 days) increased from 33.3% to 43.5%.
  • The intervention did not demonstrate a clear improvement in hospice utilization quality.

Conclusions:

  • The peer comparison intervention was insufficient to conclude improvement in hospice use quality.
  • A significant proportion of cancer patients experienced short hospice LOS, signifying poor quality care.
  • Combining peer comparison with additional behavioral interventions is recommended to enhance end-of-life care.