ArticleJournal of general internal medicine2015
Hospice use among nursing home and non-nursing home patients.
Article in Journal of general internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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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
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- What Do We Know About Hospice Enrollment for Nursing Home Residents with Cognitive Disabilities? A Systematic Review.Journal of palliative medicine · 2026Pooled it
- Duration of palliative care before death in international routine practice: a systematic review and meta-analysis.BMC medicine · 2020Pooled it
- Costs and cost-effectiveness of palliative care in residential aged care homes: a scoping review.Age and ageing · 2026Article
- Variation in Hospice Aide Care by Residential Setting.Journal of palliative medicine · 2024Article
- Mortality among Nursing Home Residents Enrolled in Hospice and Hospice Utilization Post-Hurricane Irma.Journal of palliative medicine · 2022Article
- Quality of Hospice Care at Home Versus in an Assisted Living Facility or Nursing Home.Journal of the American Geriatrics Society · 2018Article
- Variation in Hospice Services by Location of Care: Nursing Home Versus Assisted Living Facility Versus Home.Journal of the American Geriatrics Society · 2017Article
- The Frailty Phenotype and Palliative Care Needs of Older Survivors of Critical Illness.Journal of the American Geriatrics Society · 2017Article
- Effect of Hospice Use on Costs of Care for Long-Stay Nursing Home Decedents.Journal of the American Geriatrics Society · 2016Article
- Transitions Between Healthcare Settings of Hospice Enrollees at the End of Life.Journal of the American Geriatrics Society · 2016Article
- Capsule commentary on Unroe et al., hospice use among nursing home and non-nursing home patients.Journal of general internal medicine · 2015Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundFor nursing home patients, hospice use and associated costs have grown dramatically. A better understanding of hospice in all care settings, especially how patients move across settings, is needed to inform debates about appropriateness of use and potential policy reform.
objectiveOur aim was to describe characteristics and utilization of hospice among nursing home and non-nursing home patients. DESIGN AND
participantsMedicare, Medicaid and Minimum Data Set data, 1999-2008, were merged for 3,771 hospice patients aged 65 years and above from a safety net health system. Patients were classified into four groups who received hospice: 1) only in nursing homes; 2) outside of nursing homes; 3) crossover patients utilizing hospice in both settings; and 4) "near-transition" patients who received hospice within 30 days of a nursing home stay. MAIN MEASURES: Differences in demographics, hospice diagnoses and length of stay, utilization and costs are presented with descriptive statistics. KEY
resultsNursing home hospice patients were older, and more likely to be women and to have dementia (p < 0.0001). Nearly one-third (32.3 %) of crossover patients had hospice stays > 6 months, compared with the other groups (16 % of nursing home hospice only, 10.7 % of non-nursing home hospice and 7.6 % of those with near transitions) (p < 0.0001). Overall, 27.7 % of patients had a hospice stay <1 week, but there were marked differences between groups-48 % of near-transition patients vs. 7.4 % of crossover patients had these short hospice stays (p < 0.0001). Crossover and near-transition hospice patients had higher costs to Medicare compared to other groups (p < 0.05).
conclusionsDichotomizing hospice users only into nursing home vs. non-nursing home patients is difficult, due to transitions across settings. Hospice patients with transitions accrue higher costs. The impact of changes to the hospice benefit on patients who live or move through nursing homes near the end of life should be carefully considered.
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