Evidence map›Paper›PMID 42859748›Full record

ArticleHealth affairs scholar2026

Closing the hospice gap: the value of home-based medical care.

Katherine Ornstein, Bruce Leff, Maggie Salinger, Jennifer M Reckrey, Bian Liu, Zainab Toteh Osakwe, Martha Abshire Saylor, Arushi Arora, Melissa Aldridge, Krista Harrison and 2 more

Abstract read
In one paragraph

Article in Health affairs scholar, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Katherine OrnsteinCenter for Equity in Aging, School of Nursing, Johns Hopkins University, Baltimore, MD 21205, United States.ORCID https://orcid.org/0000-0001-6270-4423
Bruce LeffDivision of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD 21224, United States.
Maggie SalingerDepartment of Medicine, Warren Alpert Medical School at Brown University, Providence, RI 02903, United States.ORCID https://orcid.org/0000-0002-7972-7071
Jennifer M ReckreyDivision of Geriatric Medicine and Palliative Care, Department of Medicine, NYU Grossman School of Medicine, New York, NY 10017, United States.
Bian LiuDepartment of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.ORCID https://orcid.org/0000-0001-9166-693X
Zainab Toteh OsakweCollege of Nursing and Public Health, Adelphi University, Garden City, NY 11530, United States.
Martha Abshire SaylorCenter for Equity in Aging, School of Nursing, Johns Hopkins University, Baltimore, MD 21205, United States.ORCID https://orcid.org/0000-0003-1824-1542
Arushi AroraDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.ORCID https://orcid.org/0000-0001-8913-3544
Melissa AldridgeDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.ORCID https://orcid.org/0000-0002-3334-4542
Krista HarrisonDivision of Geriatrics and Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California San Francisco, San Francisco, CA 94158, United States.ORCID https://orcid.org/0000-0001-5373-3011
Abraham A BrodyRory Meyers College of Nursing, New York University, New York, NY 10010, United States.ORCID https://orcid.org/0000-0002-3405-7043
Christine S RitchieCenter for Optimal Aging and Serious Illness Research, Massachusetts General Hospital, Boston, MA 02114, United States.ORCID https://orcid.org/0000-0002-4881-9416

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 2013 to 2026
$19.9M
Unnecessary and Harmful Medication Use in Older Adults with DementiaP01AG066605 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KENNETH E. COVINSKY, R. Sean Morrison · 2020 to 2026
$17.7M
NIA NIH HHS P01 AG066605NIA NIH HHS P30 AG044281
6 · The paper itself

Abstract

Introduction: Home-based medical care (HBMC), longitudinal medical care provided in a patient's home led by physicians or advanced practice providers, addresses complex medical and social needs of seriously ill older adults, particularly those with dementia. We examined whether HBMC use is associated with hospice enrollment and length of stay and whether this varies by dementia status. Methods: We analyzed data from 100% fee-for-service Medicare decedents in 2019, who were eligible for HBMC prior to death. Models used inverse probability weighting, adjusting for clinical, demographic, and regional characteristics. Results: HBMC users had greater odds of hospice use (odds ratio: 1.34; 95% CI: 1.33-1.35) compared with nonusers, regardless of dementia status. For hospice enrollees, HBMC use minimized both ultra-short (<3 days) and prolonged (>180 days) stays, with a stronger reduction in short stays for patients with dementia. Conclusion: As more older adults age in the community and hospice services expand to support patients with complex illnesses such as dementia, HBMC may offer a valuable strategy for effectively navigating prognosis uncertainty and the complexities of hospice eligibility requirements and enrollment.

Indexed as

home-based medical carehospiceolder adults

Identifiers

PMID42859748
PMCPMC13653336

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.