Patient and physician characteristics affecting the choice of home based hospice, acute care inpatient hospice facility, or hospitals as last site of care for patients with cancer of the lung.

In this exploratory study we found that in 1986, in Clark County, Nevada, home based hospice services were utilized at a very limited level for lung cancer patients. A nontraditional acute care hospice facility, however, was heavily utilized; but only slightly less so than community hospitals. Using death certificate and state cancer registry data, we explored several factors affecting these choices of sites of treatment of the last episode of illness. Among them were sociodemographic characteristics of patients, physicians' specialty, and volume of patients with terminal cancer of the lung. The findings and hypotheses lend support to further studies of the most cost effective last site of care for terminal lung cancer. The need for an ongoing examination of the impact of public policy on the definition of hospice and careful consideration of nontraditional models is indicated.