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CU Study: One-Third of Discharged Hospice Patients Eligible for Further Care
DENVER (August 10, 2004) — A one-year study looking into the outcomes and characteristics of patients discharged from hospice care found that one-third of patients surveyed died within six months of their release. These results indicate an ongoing eligibility for care even under the strictest interpretation of eligibility criteria within the national Medicare Hospice Benefit.
The study, conducted by physicians from University of Colorado Denver, the Colorado Health Outcomes Program, and Hospice at Riverside and Grant in Columbus, Ohio, measured the mortality rates of discharged patients within a six-month period after their discharge. Full details of the study can be found in the August edition of the Journal of the American Geriatrics Society (August 2004, Volume 52, Number 8, pages 1 - 6).
The study followed 164 English-speaking adults in the year following care under hospice. Thirty-five percent of the patients died within six months of hospice discharge. Many of these patients died without hospice readmission, a situation that can be difficult for the patient, but also distressing to family members and hospice workers.
Congress approved the Medicare Hospice Benefit in 1982. The benefit consists of two 90-day hospice care periods and an unlimited number of 60-day periods. To be eligible for this benefit, a patient must be entitled to Medicare and have a terminal disease with a six-month or less life expectancy prognosis as certified by two physicians before admission and by the hospice medical director before each new benefit period. The difficulty is that even for the most experienced clinicians, it is not easy to predict a time period of survival for chronic, progressive illnesses.
"Given that so many of those who died within six months were still eligible for hospice care after they had been discharged, it is clear that patients who have been discharged from hospice should be followed closely to look for unmet needs and
potential readmission to hospice," said Jean Kutner, MD, MSPH, associate professor of medicine of the CU School of Medicine.
The study showed there were no significant associations based on gender, length of hospice service, diagnosis, discharge disposition, or prognosis. The strongest predictor of mortality after hospice discharge was a report that the patient's condition had worsened.
The University of Colorado Denver is one of three campuses in the University of Colorado system. Located in Denver and Aurora, Colo., the center includes schools of medicine, nursing, pharmacy, and dentistry, a graduate school and a teaching hospital. For more information, visit the Web site at www.uchsc.edu.