02:35pm Tuesday 22 October 2019

Hospice Services Reduce Repeated Hospital Stays at End of Life

A new study by University of Wisconsin-Madison geriatrics researchers analyzed nearly two million hospitalization records from Medicare beneficiaries across the United States. The researchers found that patients who were newly enrolled in hospice programs, which focus on increasing comfort and quality of life for terminally ill patients, had a significantly reduced rate of rehospitalization (“bounce-back admissions”) within 30 days of being discharged from the hospital.

The study, led by Dr. Amy Kind, geriatrics expert and associate professor of medicine, analyzed hospitalization records from 2004 through 2009. These nearly two million hospitalizations represented a national sample of five percent of all Medicare beneficiaries.

To understand the impact of new hospice-care enrollment on rehospitalization, researchers grouped hospitalization events into geographic hospital service areas and correlated them with high, medium or low use of hospice programs. They adjusted for other factors including poverty and education levels of patients, medical history and hospital characteristics such as size or rural versus urban setting.

Just 2.2 percent of patients newly enrolled in hospice were rehospitalized within 30 days, compared to 18.8 percent of non-enrollees.

First author Dr. Timothy Holden, palliative medicine fellow, says, “Hospice helps patients avoid recurrent hospitalizations, which are often unwanted and burdensome for individuals and their families. This is consistent with the goals of hospice, which provides comprehensive care focused on comfort and quality of life for seriously ill individuals nearing the end of life.”

The study also helps to inform health care systems about ways to provide high- quality care while reducing costs. The Center for Medicare and Medicaid Services (CMS) has implemented financial penalties for hospitals with unacceptably high rates of rehospitalization.

“There is a growing focus on value-based, high-quality care, which includes reducing costly and often preventable rehospitalizations. This study suggests that integrated hospice care in regional health care delivery models may be an important component in improving health care quality and patient-centered outcomes,” says Holden.

Additional UW-Madison researchers involved in the study include Dr. Maureen Smith, Dr. Christie Bartels, Dr. Toby Campbell, and Menggang Yu. The study has been published in Journal of Palliative Care Medicine.

University of Wisconsin School of Medicine and Public Health

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