Hospice: comprehensive care at the end of life.

Hospice is a health care service delivery system that provides palliative care for patients who have a limited life expectancy and require comprehensive biomedical, psychosocial, and spiritual support. This article reviews the indications and provisions for hospice care for all age groups, including issues of prognosis and the role of the physician on the hospice interdisciplinary team. Because most deaths in the United States result from chronic progressive illnesses (eg, cancer and cardiovascular, cerebrovascular, pulmonary, and neurodegenerative diseases) that affect older individuals, discussion focuses on the provisions of the Medicare Hospice Benefit, which has become an important entitlement in efforts to improve care of the dying in this country.