ArticleHealth services research2022
Effects of Medicare advantage on patterns of end-of-life care among Medicare decedents.
Article in Health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
8 citing papers in PubMed, 8 citations in OpenAlex.
- Medicare Plan Switching and Hospice Care Among Decedents With Advanced Cancer.JAMA network open · 2026Article
- Medicare Advantage Enrollment in Nursing Homes: 2010-2023.Journal of the American Geriatrics Society · 2026Article
- Effects of Medicare Advantage on preventive care use and health behavior.Health services research · 2023Article
- Comparison of the Pathway to Hospice Enrollment Between Medicare Advantage and Traditional Medicare.JAMA health forum · 2023Article
- Effects of Medicare eligibility and enrollment at age 65 years on the use of high-value and low-value care.Health services research · 2023Article
- Association of Medicare Advantage star ratings with patterns of end-of-life care.Journal of the American Geriatrics Society · 2023Article
- Comparison of Health Care Utilization by Medicare Advantage and Traditional Medicare Beneficiaries With Complex Care Needs.JAMA health forum · 2022Article
- Effects of Medicare advantage on patterns of end-of-life care among Medicare decedents.Health services research · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo examine the effects of Medicare Advantage (MA) enrollment on patterns of end-of-life care. DATA SOURCES: We used data from the Master Beneficiary Summary File, the Medicare Provider Analysis and Review, hospice claims, the Minimum Data Set, the Outcome and Assessment Information Set, the Area Health Resources File, and Geographic Variation Public Use File for 2012-2014. STUDY
designTo address selective enrollment into MA, we exploited a discontinuity in payment rates by county population (urban floor payments) as an instrument. DATA COLLECTION/EXTRACTION
methodsWe identified Medicare beneficiaries continuously enrolled in MA or TM during their last year of life between 2012 and 2014 using Medicare administrative data. PRINCIPAL
findingsWe did not find evidence that MA enrollment led to a change in hospital admissions in the last 30 days of life, but MA enrollment decreased hospital as the site of death by 11.0 (95% CI: -13.9 to -8.1) percentage points. Once hospitalized, however, MA enrollment increased use of intensive care by 6.7 (95% CI: 0.3 to 13.1) percentage points and non-invasive mechanical ventilation by 9.2 (95% CI: 5.5 to 12.9) percentage points. MA enrollment increased hospice use by 6.2 (95% CI: 2.3 to 10.1) percentage points at time of death and 7.7 (95% CI: 3.8 to 11.6) percentage points in the last 30 days of life. Particularly, MA enrollment increased hospice admissions among those who were admitted to the hospital within 30 days prior to hospice admission by 18.8 (95% CI: 13.8 to 23.8) percentage points. However, MA enrollment decreased hospice admissions among those who were admitted to home health within 30 days prior to hospice admission by 18.6 (95% CI: -21.9 to -15.2) percentage points.
conclusionsMA plans may improve end-of-life care by reducing hospital death while also improving access to hospice, especially among recently hospitalized persons.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.