Kirstin LeSage1, Andrew J Borgert2, Laura S Rhee3. 1. Department of Medical Education, Gundersen Medical Foundation, La Crosse, WI, USA kirstin_selby@yahoo.com. 2. Department of Medical Research, Gundersen Medical Foundation, La Crosse, WI, USA. 3. Department of Palliative Medicine, Gundersen Health System, La Crosse, WI, USA.
Abstract
BACKGROUND: The purpose of our study was to identify time to death and/or reenrolled patients alive at the time of hospice discharge. METHODS: Medical records of all adults alive at hospice discharge during a 5-year period were retrospectively reviewed. RESULTS: In all, 83 patients were alive at discharge, with 3 lost to follow-up. Average time from discharge to death was 199.9 days for all patients and 50 days for the 17 patients who reenrolled. Average time from discharge to reenrollment was 245 days. CONCLUSION: Our research supports past findings that over a third of patients disenrolled from hospice die within 6 months, indicating ongoing hospice eligibility up to the time of death. Interestingly, if enrollment was revoked by patient or family, as often was done to allow the patient to pursue more aggressive treatments, the mortality risk was higher in the 6 months after discharge. This should prompt careful reevaluation of disenrolled hospice patients in the months after disenrollment, and hospice reenrollment should be continually available and offered during this time.
BACKGROUND: The purpose of our study was to identify time to death and/or reenrolled patients alive at the time of hospice discharge. METHODS: Medical records of all adults alive at hospice discharge during a 5-year period were retrospectively reviewed. RESULTS: In all, 83 patients were alive at discharge, with 3 lost to follow-up. Average time from discharge to death was 199.9 days for all patients and 50 days for the 17 patients who reenrolled. Average time from discharge to reenrollment was 245 days. CONCLUSION: Our research supports past findings that over a third of patients disenrolled from hospice die within 6 months, indicating ongoing hospice eligibility up to the time of death. Interestingly, if enrollment was revoked by patient or family, as often was done to allow the patient to pursue more aggressive treatments, the mortality risk was higher in the 6 months after discharge. This should prompt careful reevaluation of disenrolled hospice patients in the months after disenrollment, and hospice reenrollment should be continually available and offered during this time.
Authors: Alissa J Cooper; Steven P Keller; Christina Chan; Brett E Glotzbecker; Michael Klompas; Rebecca M Baron; Chanu Rhee Journal: Ann Am Thorac Soc Date: 2020-04