Eli's Hospice Insider

Published on Mon Dec 15, 2014 PDF

75 percent of non-hospice patients died in facilities vs. 14 percent of hospice patients.

Giving your patients quality care while they stay at home for end of life may be your goal, but you are saving Medicare money in the meantime.

So says another new study on the topic, which found that patients in hospice are less likely to die in a hospital or nursing home, and less likely to get costly and intensive care, than terminally ill patients who don’t opt for hospice care. Researchers from Harvard University and Brigham & Women’s Hospital studied more than 36,000 patients with poor-prognosis cancers who died in 2011, according to the study published in the Nov. 12 issue of the Journal of the American Medical Association.

Researchers matched and compared two groups who died at the same time — those who enrolled in hospice and those who didn’t. Hospice patients endured fewer invasive procedures and fewer hospital stays at the end of their lives, they found. Most of the invasive procedures were for problems unrelated to the cancer.

Bottom line: Total costs over the last year of life were $71,517 for nonhospice and $62,819 for hospice patients. Nearly 75 percent of nonhospice patients died in hospitals or nursing homes, compared to 14 percent of hospice patients, says the study.

Discussing hospice as an option for the terminally ill may prevent that intensive care, the study’s lead author told Reuters. “There is a lot of evidence that a lot of people don’t have these conversations,” said Dr. Ziad Obermeyer, a physician at Brigham & Women’s Hospital in Boston. “So they get sucked into this intense care option without even talking about it.”

Obermeyer said doctors need to have earlier conversations about the end of life. “Doctors need to be frank about giving patients the information even though it’s uncomfortable, so that patients have a choice in the care that they want,” he told Reuters.

The entire study is available at http://jama.jamanetwork.com/article.aspx?articleid=1930818. An editorial on the topic is available for purchase at http://jama.jamanetwork.com/article.aspx?articleid=1930801.