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Elder Care News
Nursing Home Hospice Care Reduces End-of-Life
Hospitalizations
By Katherine Kahn, Contributing Writer
Health Behvior News Service
August 18, 2006 - Nursing home residents in hospice
care have about half the chance of being admitted to a hospital in their
last 30 days of life compared to peers who dont receive hospice care, a
large new study confirms.
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Our study provides strong evidence that access to
hospice in nursing homes significantly reduces hospitalization, said
study author Pedro Gozalo, Ph.D.
Gozalo and co-investigator Susan Miller, Ph.D., of
Brown Medical School, examined data from 183,742 nursing home residents
in five states. The retrospective study is published online in Health
Services Research.
People who choose hospice, which focuses on comfort
instead of cure, tend to refuse aggressive end-of-life treatment anyway,
Gozalo said. But even taking this into consideration, hospice still
makes a significant difference in keeping people out of the hospital in
their last days, the study shows.
The study also looked at characteristics of nursing
home residents who receive hospice care. They are more likely to have a
cancer diagnosis, although two-thirds of nursing- home residents in
hospice have a noncancer diagnosis, Gozalo said. Hospice patients are
also more likely to be female, white and married compared to residents
not receiving hospice care.
Other factors, such as nursing-home location, also
influence enrollment in hospice. For example, nursing homes with hospice
providers farther than 15 miles away had fewer residents using these
services. In addition, enrollment in hospice varies widely from state to
state.
Hospitalizing a terminally ill patient may
negatively affect that persons remaining quality of life. From an
economic standpoint, such hospitalizations can result in large and
unwarranted expenditures.
About 80 percent of nursing homes now have
arrangements to provide hospice care, Gozalo said, but that doesnt
mean access is a given. Failing to identify residents who need hospice,
financial incentives for nursing homes to keep providing skilled care
and local health system policy may affect access to hospice services,
Miller said.
Susan Mitchell, M.D., an associate professor at
Harvard Medical School, said, Families of nursing home residents need
to know hospice is an option and that their loved one is entitled to the
Medicare hospice benefit. They can request hospice from the doctor or
social worker. They can also contact a hospice provider themselves, if
the nursing home does not offer hospice care, Mitchell said.
The study was funded by a grant from the Agency of
Healthcare Research and Quality, U.S. Department of Health and Human
Services.
Notes:
Health Behavior News Service:
http://www.hbns.org.
Health Services Research is the official journal of
the AcademyHealth and is published by Blackwell Publishing on behalf of
the Health Research and Educational Trust. For information, contact
Jennifer Shaw, HSR Business Manager at (312) 422-2646 or jshaw@aha.org.
HSR is available online
click here.
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