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Updated: Jul 1, 2026
04:57
Establishing a Competing Risk Regression Nomogram Model for Survival Data
Published on: October 23, 2020
Survival Heterogeneity in U.S. Hospice Patients: A Retrospective Cohort Study
Ian Duncan1, Xiyue Liao2, Terri Maxwell3
1Department of Statistics & Applied Probability, University of California Santa Barbara, Santa Barbara, CA, USA.
The American Journal of Hospice & Palliative Care
|June 29, 2026
Summary
Hospice care survival varies significantly. Analgesic and anxiolytic use in hospice patients is linked to a higher mortality hazard, indicating potential symptom burden and informing care planning.
Area of Science:
- Palliative Care
- Gerontology
- Clinical Pharmacy
Background:
- Hospice care is a vital part of end-of-life care in the U.S.
- Patient survival in hospice exhibits considerable variability due to patient, provider, family, and cultural factors.
- A significant portion of hospice patients exceed the 180-day Medicare hospice benefit duration.
Purpose of the Study:
- To investigate factors influencing hospice patient survival variability.
- To analyze the impact of demographics, diagnoses, care setting, and medication use on mortality hazard.
- To understand medication trajectories as indicators of symptom burden and needs for individualized care planning.
Main Methods:
- Utilized Cox proportional hazards models to assess time-to-event (death in hospice).
- Evaluated covariates including demographics, diagnoses, and care setting.
- Examined medication exposure variables, specifically analgesic and anxiolytic use.
Main Results:
- Analgesic use was associated with a nearly three-fold higher mortality hazard (HR = 2.977).
- Anxiolytic use was associated with a roughly two-fold higher mortality hazard (HR = 1.910) compared to non-users.
- Medication exposure demonstrated a strong association with mortality hazard in hospice patients.
Conclusions:
- Medication use near end-of-life is a significant factor in hospice survival variability.
- Medication trajectories can serve as valuable indicators of symptom burden.
- Findings support individualized care planning and highlight the importance of medication management in hospice.
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