Factors in Late Hospice Admission for Cancer Identified
Late admission more likely for younger patients, married men, hematologic malignancies.
For patients with cancer, factors associated with late admission to hospice have been identified, according to a study published online in the Journal of Clinical Oncology.
Nina R. O'Connor, M.D., from the University of Pennsylvania, and colleagues evaluated electronic health records for patients with cancer admitted to 12 hospices in the Coalition of Hospices Organized to Investigate Comparative Effectiveness network. The authors examined patient characteristics associated with hospice enrollment in the last three days of life.
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The researchers found that 16.3 percent of the 64,264 patients admitted to hospice with cancer had a length of stay of three days or less. The proportion of patients enrolled in the last three days of life varied considerably among hospices (range, 11.4 to 24.5 percent).
In multivariable analysis, patients who were admitted in the last three days of life were more likely to have a hematologic malignancy; were more likely to be male and married; and were younger (age < 65 years). Admission to hospice within three days of death was less likely for those with Medicaid or self-insurance.
"Quality measures of hospice lengths of stay should include patient-mix adjustments for type of cancer and site of care," the authors write.