ArticleJournal of the American Geriatrics Society2020
Hospice Utilization in the United States: A Prospective Cohort Study Comparing Cancer and Noncancer Deaths.
Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 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
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Factors influencing accessibility of palliative care: a systematic review and meta-analysis.BMC palliative care · 2025Pooled it
- Psychological problems among cancer patients in relation to healthcare and societal costs: A systematic review.Psycho-oncology · 2021Pooled it
- A Psychometric Evaluation of the Staff-Reported EOLD-CAD Measure Among Nursing Home Residents With Cognitive Impairment.International journal of geriatric psychiatry · 2025Trial
- Insomnia Symptoms Among Hospice Family Caregivers: Prevalence and Association with Caregiver Mental and Physical Health, Quality of Life, and Caregiver Burden.The American journal of hospice & palliative care · 2023Trial
- How Hospice and Palliative Care Are Portrayed in Artificial Intelligence-Generated Images: A Content Analysis.Journal of palliative medicine · 2026Article
- Disability free life expectancy: a simulation study of scenarios to extend healthy years and reduce inequalities.BMC medicine · 2026Article
- Trends in preferred place of death among patients with bladder cancer in the United States, 2000 to 2020.Palliative & supportive care · 2026Article
- "Hospice was Created by the KKK"-Black Americans' Perspectives on Hospice Care.Journal of racial and ethnic health disparities · 2026Article
- Oncology-embedded supportive care and end-of-life outcomes: a comparative study of hospice-eligible Muslim patients with cancer and non-cancer diagnoses.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Trends and factors associated with hospice care utilization and place of death in the United States between 2002 and 2020: a retrospective data analysis based on the health and retirement study.BMC palliative care · 2026Article
- Medicare Plan Switching and Hospice Care Among Decedents With Advanced Cancer.JAMA network open · 2026Article
- State-Level Variability in Location of Death of Patients with End-Stage Liver Disease.Digestive diseases and sciences · 2026Article
- Place of death among adults with interstitial lung disease in the United States, 1999-2023: a national population-based study.Annals of medicine and surgery (2012) · 2026Review
- End-of-life issues in older adults: Emotional and social factors that shape end-of-life experiences.Advances in psychiatry and behavioral health · 2025Article
- Trends and disparities in place of death among patients with cholangiocarcinoma: A two-decade analysis.Palliative & supportive care · 2025Article
- The Impact of Advanced Care Planning on Hospice Utilization in Patients with Cancer: A Nationwide Analysis in Korea.Cancers · 2025Article
- Trends of hospice utilization in Korea before and after the COVID- 19 pandemic in patients with cancer: an interrupted time series analysis using nationwide data.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Contemporary Patterns of End-of-Life Care Among Medicare Beneficiaries With Advanced Cancer.JAMA health forum · 2025Article
- Trends in palliative care utilization among older adult decedents with and without cancer in Taiwan: a population-based comparative study.The Lancet regional health. Western Pacific · 2025Article
- Navigating a "Good Death" During COVID-19: Understanding Real-Time End-of-Life Care Structures, Processes, and Outcomes Through Clinical Notes.The Gerontologist · 2024Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesReliable national estimates of hospice use and underuse are needed. Additionally, drivers of hospice use in the United States are poorly understood, especially among noncancer populations. Thus the objectives of this study were to (1) provide reliable estimates of hospice use among adults in the United States; and (2) identify factors predicting use among decedents and within subsamples of cancer and noncancer deaths.
designWe conducted a prospective cohort study using the Health and Retirement Study survey. Excluding sudden deaths, we used data from the 2012 survey wave to predict hospice use in general, and then separately for cancer and non-cancer deaths.
settingStudy data were provided by a population-based sample of older adults from the U.S.
participantsWe constructed a sample of 1,209 participants who died between the 2012 and 2014 survey waves. MEASUREMENTS: Hospice utilization was reported by proxy. Exposure variables included demographics, functionality (activities of daily living [ADLs]), health, depression, dementia, advance directives, nursing home residency, and cause of death.
resultsHospice utilization rate was 52.4% for the sample with 70.8% for cancer deaths and 45.4% for noncancer deaths. Fully adjusted model results showed being older (odds ratio [OR] = 1.54), less healthy (OR = .79), having dementia (OR = 1.52), and having cancer (OR = 5.47) were linked to greater odds of receiving hospice. Among cancer deaths, being older (OR = 1.64) and female (OR = 2.54) were the only predictors of hospice use. Among noncancer deaths, increased age (OR = 1.58), more education (OR = 1.56), being widowed (OR = 1.55), needing help with ADLs (OR = 1.13), and poor health (OR = .77) were associated with hospice utilization.
conclusionFindings suggest hospice remains underutilized, especially among individuals with noncancer illness. Extrapolating results to the US population, we estimate that annually nearly a million individuals who are likely eligible for hospice die without its services. Most (84%) of these decedents have a noncancer condition. Interventions are needed to increase appropriate hospice utilization, particularly in noncancer care settings. J Am Geriatr Soc 68:783-793, 2020.
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