Leaving Hospice Prematurely May Hike Health
WEDNESDAY, Sept. 29 (HealthDay News) -- Terminally ill cancer
patients who choose to leave a hospice center incur significantly
greater health-care costs than patients who remain in hospice care
until death, new research shows.
Former hospice residents incur expenses almost five times that
of hospice patients, in part because of their greater use of
emergency rooms (ERs) and more frequent hospitalizations, according
to a study reported in the Oct. 1 issue of the
Journal of Clinical Oncology.
Melissa D.A. Carlson, an assistant professor of geriatrics and
palliative medicine at Mount Sinai Medical Center in New York City,
and Elizabeth H. Bradley, a professor of public health at Yale
University in New Haven, Conn., led a research team that analyzed
Medicare data collected between 1998 and 2002 involving 90,826
cancer patients who received care at one of nearly 1,400
About 11 percent of the patients ultimately left their hospice,
the researchers noted. Of these, nearly 34 percent went on to be
admitted to an ER, compared with about 3 percent of those who
stayed in hospice.
While about 40 percent of ex-hospice patients required hospital
admission for inpatient care, the same was true for less than 2
percent of those who remained in hospice. And ex-hospice patients
stayed in the hospital a lot longer on average than continuing
hospice patients -- about 19 days versus just under seven days,
Such extra health-care expenses among the ex-hospice population
-- alongside a greater need for home health care, medical equipment
and supplies, and outpatient care -- upped the tally considerably,
the researchers concluded.
"Our data suggest that oncologists should be aware of the dramatic financial and physical toll that disenrolling from hospice can have on a patient with cancer," Carlson said in a news release from the Mount Sinai Medical Center.
Their effort did not look into what exactly motivated patients
to leave a hospice in the first place.
"We do not really understand why some patients disenroll from hospice, especially as many had conditions that typically fit hospice care," noted Bradley. "The number was higher than we expected and would be good to investigate further."
For more on hospice care for cancer patients, visit the
National Cancer Institute.
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