Evidence map›Paper›PMID 38142043›Full record

ArticleJournal of cardiac failure2024

Factors Associated With Mortality and Hospice Use Among Medicare Beneficiaries With Heart Failure Who Received Home Health Services.

Christine D Jones, Angela Moss, Carter Sevick, Marisa Roczen, Madeline R Sterling, Jennifer Portz, Hillary D Lum, Amy Yu, Jacqueline A Urban, Prateeti Khazanie

Abstract readMulticenter Study
In one paragraph

Article in Journal of cardiac failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Christine D JonesVeterans Health Administration, Eastern Colorado Health Care System, Denver-Seattle Center of Innovation for Veteran-Centered and Value Driven Care, Aurora, CO; Division of Hospital Medicine, Department of Medicine, University of Colorado, Aurora, CO; Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO; Division of Geriatrics, Department of Medicine, University of Colorado, Aurora, CO. Electronic address: Christine.Jones@cuanschutz.edu.
Angela MossAdult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
Carter SevickAdult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
Marisa RoczenAbt Associates. Denver, CO.
Madeline R SterlingDivision of General Internal Medicine, Department of Medicine at Weill Cornell Medicine, New York, NY.
Jennifer PortzDivision of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO.
Hillary D LumDivision of Geriatrics, Department of Medicine, University of Colorado, Aurora, CO.
Amy YuDivision of Hospital Medicine, Department of Medicine, University of Colorado, Aurora, CO.
Jacqueline A UrbanDivision of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, CO.
Prateeti KhazanieAdult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO; Division of Cardiology, Department of Medicine, University of Colorado, Aurora, CO.

Funding

Effectiveness of Engaging in Advance Care Planning Talks (ENACT) Group Visits Intervention in Primary Care for Older Adults with and without Alzheimer's DementiaR01AG066804 · NIA · UNIVERSITY OF COLORADO DENVER · PI LUM, HILLARY · 2021 to 2025
$3.7M
Variations in Use of Heart Replacement Therapies Among Patients with Advanced Heart FailureK23HL145122 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI KHAZANIE, PRATEETI · 2019 to 2023
$961k
Leveraging Home Health Aides to Improve Outcomes in Heart FailureK23HL150160 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI STERLING, MADELINE R · 2020 to 2024
$921k
Social Convoy Palliative Care (Convoy-Pal) Mobile Health for Older Adults with Advanced Heart FailureK76AG059934 · NIA · UNIVERSITY OF COLORADO DENVER · PI PORTZ, JENNIFER · 2018 to 2022
$892k
Development and evaluation of a palliative-transitional home health care modelR21AG067038 · NIA · UNIVERSITY OF COLORADO DENVER · PI JONES, CHRISTINE D · 2020 to 2021
$428k
NHLBI NIH HHS K23 HL145122NHLBI NIH HHS K23 HL150160NIA NIH HHS K76 AG059934NIA NIH HHS R01 AG066804NIA NIH HHS R21 AG067038
6 · The paper itself

Abstract

backgroundAlthough many Medicare beneficiaries with heart failure (HF) are discharged with home health services, little is known about mortality rates and hospice use in this group.

objectivesTo identify risk factors for 6-month mortality and hospice use among patients hospitalized due to HF who receive home health care, which could inform efforts to improve palliative and hospice use for these patients.

methodsA retrospective cohort analysis was conducted in a 100% national sample of Medicare fee-for-service beneficiaries with HF who were discharged to home health care between 2017 and 2018. Multivariable Cox regression models examined factors associated with 6-month mortality, and multivariable logistic regression models examined factors associated with hospice use at the time of death.

resultsA total of 285,359 Medicare beneficiaries were hospitalized with HF and discharged with home health care; 15.5% (44,174) died within 6 months. Variables most strongly associated with mortality included: age > 85 years (hazard ratio [HR] 1.66, 95% CI 1.61-1.71), urgent/emergency hospital admission (HR 1.68, 1.61-1.76), and "serious" condition compared to "stable" condition (HR 1.64, CI 1.52-1.78). Among 44,174 decedents, 48.2% (21,284) received hospice care at the time of death. Those with lower odds of hospice use at death included patients who were: < 65 years (odds ratio [OR] 0.65, CI 0.59-0.72); of Black (OR 0.64, CI 0.59-0.68) or Hispanic race/ethnicity (OR 0.79, CI 0.72-0.88); and Medicaid-eligible (OR 0.80, CI 0.76-0.85).

conclusionsAlthough many patients hospitalized for HF are at risk of 6-month mortality and may benefit from palliative and/or hospice services, our findings indicate under-use of hospice care and important disparities in hospice use by race/ethnicity and socioeconomic status.

Indexed as

Heart FailureHome Care ServicesHospice CareMedicareAgedAged, 80 and overFemaleHospitalizationHumansMaleRetrospective StudiesRisk FactorsUnited StatesHeart failurehome health carehospicemortalitypalliative care

Identifiers

PMID38142043
PMCPMC11402469

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Registered trials

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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.