ArticleJournal of the American Medical Directors Association2013
Hospice use among nursing home patients.
Article in Journal of the American Medical Directors Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sociodemographic Disparities in the Use of Hospice by U.S. Nursing Home Residents: A Systematic Review.The American journal of hospice & palliative care · 2026Pooled it
- End of life care for long-term care residents with dementia, chronic illness and cancer: prospective staff survey.BMC geriatrics · 2019Article
- Quality of Hospice Care at Home Versus in an Assisted Living Facility or Nursing Home.Journal of the American Geriatrics Society · 2018Article
- Are Trends in Hospitalization Prior to Hospice Use Associated With Hospice Episode Characteristics?The American journal of hospice & palliative care · 2017Observational
- Variation in Hospice Services by Location of Care: Nursing Home Versus Assisted Living Facility Versus Home.Journal of the American Geriatrics Society · 2017Article
- Patterns of Emergency Department Use Among Long-Stay Nursing Home Residents With Differing Levels of Dementia Severity.Journal of the American Medical Directors Association · 2016Observational
- Effect of Hospice Use on Costs of Care for Long-Stay Nursing Home Decedents.Journal of the American Geriatrics Society · 2016Article
- Hospice use among nursing home and non-nursing home patients.Journal of general internal medicine · 2015Article
- Hospice family members' perceptions of and experiences with end-of-life care in the nursing home.Journal of the American Medical Directors Association · 2014Article
- Emergency Department Use Among Older Adults With Dementia.Alzheimer disease and associated disordersArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivesAmong hospice patients who lived in nursing homes, we sought to: (1) report trends in hospice use over time, (2) describe factors associated with very long hospice stays (>6 months), and (3) describe hospice utilization patterns. DESIGN, SETTING, AND
participantsWe conducted a retrospective study from an urban, Midwest cohort of hospice patients, aged ≥ 65 years, who lived in nursing homes between 1999 and 2008. MEASUREMENTS: Demographic data, clinical characteristics, and health care utilization were collected from Medicare claims, Medicaid claims, and Minimum Data Set assessments. Patients with overlapping nursing home and hospice stays were identified. χ(2) and t tests were used to compare patients with less than or longer than a 6-month hospice stay. Logistic regression was used to model the likelihood of being on hospice longer than 6 months.
resultsA total of 1452 patients received hospice services while living in nursing homes. The proportion of patients with noncancer primary hospice diagnoses increased over time; the mean length of hospice stay (114 days) remained high throughout the 10-year period. More than 90% of all patients had 3 or more comorbid diagnoses. Nearly 20% of patients had hospice stays longer than 6 months. The hospice patients with stays longer than 6 months were observed to have a smaller percentage of cancer (25% vs 30%) as a primary hospice diagnosis. The two groups did not differ by mean cognitive status scores, number of comorbidities, or activities of daily living impairments. The greater than 6 months group was much more likely to disenroll before death: 33.9% compared with 13.8% (P < .0001). A variety of patterns of utilization of hospice across settings were observed; 21% of patients spent some of their hospice stay in the community.
conclusionsAny policy proposals that impact the hospice benefit in nursing homes should take into account the difficulty in predicting the clinical course of these patients, varying utilization patterns and transitions across settings, and the importance of supporting multiple approaches for delivery of palliative care in this setting.
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