Discussing end of life care options

Too little research has been performed to determine exactly what hospice practices and services make the biggest impact on patient outcomes. While the Affordable Care Act requires hospices to report on specific practices being used, they do not require information on how these practices ultimately affect patients. A research team at the Icahn School of Medicine at Mount Sinai recently set out to determine how these hospice practices influenced patients' hospitilzations and which were the most beneficial. 

To begin, the researchers segmented a group of about 150 thousand Medicare beneficiaries enrolled in hospices throughout the US. Those that were studied entered hospice between 2008 and 2011 and were tracked until their deaths. The team noted each patient's hospital admittal, both emergency department visits and intensive care unit stays, and the location of each death. 

They studied six hospice practices, but of that group, only two were determined to make a significant impact on a patient's need for hospital admittance. 

First, hospices that talked to their patients about their preference on dying at home versus in a hospital or nursing facility reported lower odds of hospital deaths for their patients. Interestingly, those hospices also were determined to have lower odds of emergency department visits while a patient was enrolled in hospice care. 

Second, hospices that regularly monitored a patient's symptoms, at intervals at least every few days, showed lower odds of patients being admitted to the ICU. 

Neither of these are complex processes, but these findings suggesting they can have a significant impact on a patient's end of life care and quality of life can be used by hospices nationwide to lower hospitalization costs and improve the quality of care for patients. 

Ensuring that all hospices deliver these beneficial practices to each patient would have an enormous impact due to the growing rate of hospice use in the US. Hospice enrollment has grown by 20% over the past decade, and about 45 percent of terminally ill patients in the US die under hospice care. 

The results of this study suggest that not every hospice is created equal, and that the specific services and practices offered should be a determinant for individual's before enrolling themselves or their loved ones. 

To learn about our practices, goals, and philosophy of care at Cura-HPC, we invite you to contact us to schedule a consultation: (800) 797-3839.