Melissa D Aldridge1, Maureen Canavan, Emily Cherlin, Elizabeth H Bradley. 1. *Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York †James J. Peters VA Medical Center, Bronx, NY ‡Department of Health Policy and Management, Yale School of Public Health, New Haven, CT.
Abstract
BACKGROUND: Hospice use has increased substantially during the past decade by an increasingly diverse patient population; however, little is known about patterns of hospice use and how these patterns have changed during the past decade. OBJECTIVE: To characterize Medicare hospice users in 2000 and 2010 and estimate the prevalence of (1) very short (≤1 wk) hospice enrollment; (2) very long (>6 mo) hospice enrollment; and (3) hospice disenrollment and how these utilization patterns have varied over time and by patient and hospice characteristics. RESEARCH DESIGN: Cross-sectional analysis of Medicare hospice claims data from 2000 and 2010. SUBJECTS: All US Medicare Hospice Benefit enrollees in 2000 (N=529,573) and 2010 (N=1,150,194). RESULTS: As of 2010, more than half (53.4%) of all Medicare decedents who used hospice had either very short (≤1 wk, 32.4%) or very long (>6 mo, 13.9%) hospice enrollment or disenrolled from hospice before death (10.6%). This represents an increase of 4.9 percentage points from 2000. In multivariable analysis, patients with noncancer diagnoses, the fastest growing group of hospice users, were approximately twice as likely as those with cancer to have very short or long enrollment periods and to disenroll from hospice. CONCLUSION: The substantial proportion of hospice users with very short or long enrollment, or enrollments that end before death, underscores the potential for interventions to improve the timing and appropriateness of hospice referral so that the full benefits of hospice are received by patients and families.
BACKGROUND: Hospice use has increased substantially during the past decade by an increasingly diverse patient population; however, little is known about patterns of hospice use and how these patterns have changed during the past decade. OBJECTIVE: To characterize Medicare hospice users in 2000 and 2010 and estimate the prevalence of (1) very short (≤1 wk) hospice enrollment; (2) very long (>6 mo) hospice enrollment; and (3) hospice disenrollment and how these utilization patterns have varied over time and by patient and hospice characteristics. RESEARCH DESIGN: Cross-sectional analysis of Medicare hospice claims data from 2000 and 2010. SUBJECTS: All US Medicare Hospice Benefit enrollees in 2000 (N=529,573) and 2010 (N=1,150,194). RESULTS: As of 2010, more than half (53.4%) of all Medicare decedents who used hospice had either very short (≤1 wk, 32.4%) or very long (>6 mo, 13.9%) hospice enrollment or disenrolled from hospice before death (10.6%). This represents an increase of 4.9 percentage points from 2000. In multivariable analysis, patients with noncancer diagnoses, the fastest growing group of hospice users, were approximately twice as likely as those with cancer to have very short or long enrollment periods and to disenroll from hospice. CONCLUSION: The substantial proportion of hospice users with very short or long enrollment, or enrollments that end before death, underscores the potential for interventions to improve the timing and appropriateness of hospice referral so that the full benefits of hospice are received by patients and families.
Authors: Donald H Taylor; Karen Steinhauser; James A Tulsky; John Rattliff; Courtney Harold Van Houtven Journal: Am J Hosp Palliat Care Date: 2008-01-15 Impact factor: 2.500
Authors: Alison E Kris; Emily J Cherlin; Holly Prigerson; Melissa D A Carlson; Rosemary Johnson-Hurzeler; Stanislav V Kasl; Elizabeth H Bradley Journal: Am J Geriatr Psychiatry Date: 2006-03 Impact factor: 4.105
Authors: Elizabeth Rickerson; Joan Harrold; Jennifer Kapo; Janet T Carroll; David Casarett Journal: J Am Geriatr Soc Date: 2005-05 Impact factor: 5.562
Authors: Melissa D Aldridge Carlson; Colleen L Barry; Emily J Cherlin; Ruth McCorkle; Elizabeth H Bradley Journal: Health Aff (Millwood) Date: 2012-12 Impact factor: 6.301
Authors: Melissa D A Carlson; Jeph Herrin; Qingling Du; Andrew J Epstein; Emily Cherlin; R Sean Morrison; Elizabeth H Bradley Journal: Health Serv Res Date: 2009-07-27 Impact factor: 3.402
Authors: Laura P Gelfman; Yolanda Barrón; Stanley Moore; Christopher M Murtaugh; Anuradha Lala; Melissa D Aldridge; Nathan E Goldstein Journal: JACC Heart Fail Date: 2018-08-08 Impact factor: 12.035
Authors: Laura P Gelfman; Marie Bakitas; Lynne Warner Stevenson; James N Kirkpatrick; Nathan E Goldstein Journal: J Palliat Med Date: 2017-05-12 Impact factor: 2.947
Authors: Eli L Diamond; Katherine S Panageas; Alexis Dallara; Ariel Pollock; Allison J Applebaum; Alan C Carver; Elena Pentsova; Lisa M DeAngelis; Holly G Prigerson Journal: J Pain Symptom Manage Date: 2016-11-01 Impact factor: 3.612
Authors: Katherine A Ornstein; Melissa D Aldridge; Christine A Mair; Rebecca Gorges; Albert L Siu; Amy S Kelley Journal: J Palliat Med Date: 2016-03-18 Impact factor: 2.947
Authors: Melissa D Aldridge; Andrew J Epstein; Abraham A Brody; Eric J Lee; Emily Cherlin; Elizabeth H Bradley Journal: Med Care Date: 2016-07 Impact factor: 2.983