Home Health Care and Hospice Use Among Medicare Beneficiaries With and Without a Diagnosis of Dementia
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View abstract on PubMed
Summary
This summary is machine-generated.Home health care use in the final years of life increases hospice care utilization among Medicare beneficiaries. This association was stronger for individuals without dementia compared to those with dementia.
Area Of Science
- Gerontology
- Health Services Research
- Palliative Care
Background
- Home health care is a key Medicare and Medicaid benefit.
- It aims to improve health, maintain function, or slow decline.
- Understanding its role near end-of-life is crucial.
Purpose Of The Study
- To investigate the link between home health care use in the last three years of life and hospice use in the last six months of life.
- To compare this relationship among Medicare beneficiaries with and without dementia.
Main Methods
- Retrospective cohort study of nationally representative Medicare beneficiaries who died in 2019.
- Analyzed data from over 2 million beneficiaries with continuous enrollment for at least three years.
- Examined home health care initiation timing as the independent variable and hospice use/duration as outcomes.
Main Results
- 46.4% of beneficiaries used home health care; 53.1% used hospice care; 28.3% used both.
- Starting home health care, especially in the final year of life, significantly increased hospice use (OR=1.75).
- The association between home health care and hospice use was stronger in beneficiaries without dementia.
Conclusions
- Home health care use preceding end-of-life is associated with higher hospice utilization.
- This relationship holds for beneficiaries with and without dementia, though it is more pronounced in those without dementia.
- Findings highlight the interconnectedness of post-acute and end-of-life care services.
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