JAMA Study: Hospice Patients Face Fewer Procedures, Lower Costs

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
Hospice Patients Face Fewer Procedures, Lower Costs

Saving unnecessary pain. Preserving dignity. Keeping patients at home. Respecting patient wishes at the end of life. These have long been the hallmarks of the modern hospice movement.

An original investigation in the Nov. 12 Journal of the American Medical Association (JAMA) shows that not only does hospice for cancer patients lower the incidence of invasive procedures and hospital stays among cancer patients who use hospice, it also saves a significant amount of money over those who don’t.

At the baseline analysis, hospice and nonhospice patients with poor-prognosis cancers were evenly matched in terms of spending. But over the last year of life, those in the hospice group spent 12% less than those in the nonhospice group ($62,819 versus $71,517). What’s more, hospice users had fewer hospitalizations, fewer invasive procedures, less time spent in intensive care and a far greater chance of dying at home rather than a care facility.

Looking at the records of more than 86,000 patients with poor-prognosis cancers, 18,165 hospice users and 18,165 nonhospice users were matched based on age, sex, region, time from diagnosis to death and baseline care utilization. Median hospice duration was 11 days.

The results showed that nonhospice beneficiaries were:

  • Hospitalized 55% more often (65% versus 42%)
  • 140% more likely to be admitted to the ICU (36% versus 15%)
  • Nearly 90% more likely to have an invasive procedure (51% versus 27%)
  • More than four times more likely to die in an institution (74% versus 14%)

I’ve written previously about the Institute of Medicine’s landmark study that shows 90% of us believe it’s important to have end-of-life discussions with our loved ones, but fewer than one in three actually do.

The hospice industry is becoming more mainstream year by year, but there’s obviously much more hospice agencies and industry organizations can do to further the conversation.

Please leave a comment and tell us what you’re doing to spread awareness of hospice in your community.

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