ArticleAnnals of internal medicine2017
The Relationship of Obesity to Hospice Use and Expenditures: A Cohort Study.
Article in Annals of internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers, 1 of them a synthesis 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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Duration of palliative care before death in international routine practice: a systematic review and meta-analysis.BMC medicine · 2020Pooled it
- Expert Consensus on Obesity Management Protocols - A Joint Position Statement by Obesity and Metabolic Surgery Society of India (OSSI) and Endocrine Society of India (ESI).Obesity surgery · 2026Review
- Do patients with migraine and obesity receive different treatments? Insights from real-world data.Headache · 2026Article
- Change in Code Status Orders of Hospitalized Adults With COVID-19 Throughout the Pandemic: A Retrospective Cohort Study.Journal of palliative medicine · 2023Article
- Trends in Obesity Prevalence among US Older Adults in the Last Two Years of Life, 1998-2018.Journal of pain and symptom management · 2023Article
- Obesity and the Receipt of Prescription Pain Medications in the US.Journal of general internal medicine · 2021Article
- Excess Costs and Economic Burden of Obesity-Related Cancers in the United States.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2019Article
- Obesity and intensive staffing needs of nursing home residents.Geriatric nursing (New York, N.Y.) · 2018Article
- Obesity, metabolic abnormalities, and mortality in older men.Journal of geriatric cardiology : JGC · 2018Article
- Supportive and Palliative Care Needs of the Older Adults with Stroke and Neurological Diseases: An Estimation using data from Longitudinal Ageing Study in India.Indian journal of palliative careArticle
- Closing the Gap in Hospice Utilization for the Minority Medicare Population.Gerontology & geriatric medicineArticle
Corrections and comments
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundObesity complicates medical, nursing, and informal care in severe illness, but its effect on hospice use and Medicare expenditures is unknown.
objectiveTo describe the associations between body mass index (BMI) and hospice use and Medicare expenditures in the last 6 months of life.
designRetrospective cohort.
settingThe HRS (Health and Retirement Study).
participants5677 community-dwelling Medicare fee-for-service beneficiaries who died between 1998 and 2012. MEASUREMENTS: Hospice enrollment, days enrolled in hospice, in-home death, and total Medicare expenditures in the 6 months before death. Body mass index was modeled as a continuous variable with a quadratic functional form.
resultsFor decedents with BMI of 20 kg/m2, the predicted probability of hospice enrollment was 38.3% (95% CI, 36.5% to 40.2%), hospice duration was 42.8 days (CI, 42.3 to 43.2 days), probability of in-home death was 61.3% (CI, 59.4% to 63.2%), and total Medicare expenditures were $42 803 (CI, $41 085 to $44 521). When BMI increased to 30 kg/m2, the predicted probability of hospice enrollment decreased by 6.7 percentage points (CI, -9.3 to -4.0 percentage points), hospice duration decreased by 3.8 days (CI, -4.4 to -3.1 days), probability of in-home death decreased by 3.2 percentage points (CI, -6.0 to -0.4 percentage points), and total Medicare expenditures increased by $3471 (CI, $955 to $5988). For morbidly obese decedents (BMI ≥40 kg/m2), the predicted probability of hospice enrollment decreased by 15.2 percentage points (CI, -19.6 to -10.9 percentage points), hospice duration decreased by 4.3 days (CI, -5.7 to -2.9 days), and in-home death decreased by 6.3 percentage points (CI, -11.2 to -1.5 percentage points) versus decedents with BMI of 20 kg/m2. LIMITATION: Baseline data were self-reported, and the interval between reported BMI and time of death varied.
conclusionAmong community-dwelling decedents in the HRS, increasing obesity was associated with reduced hospice use and in-home death and higher Medicare expenditures in the last 6 months of life. PRIMARY FUNDING SOURCE: Robert Wood Johnson Foundation Clinical Scholars Program.
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