In a new study published recently in the Journal of the American Medical Association, researchers from Brigham and Women’s Hospital in Boston, Massachusetts, examined hospice care in terms of its impact on the intensity of treatment for advanced cancer, specifically in a sample of elderly patients on Medicare.
They discovered that those patients who were enrolled in hospice care had lower rates of health care utilization, and their costs for care were less during their last year of life. Alternatively, those patients who did not enroll in hospice received significantly more aggressive care in their last year of life, most of which was related to acute complications of their treatment, such as infections or organ failure.
In addition, 74% of those patients who did not enroll in hospice care died in hospitals and nursing facilities, whereas only 14% of those that were in hospice died in a hospital setting. The cost of care for patients not in hospice also rose sharply during the last year of life.
The investigators emphasized that these results show that doctors need to have more honest, open discussions about the goals for end-of-life care, particularly as it relates to the patients’ quality of life and treatment decisions.
More patients with cancer use hospice today than ever before, but there are indications that care intensity outside of hospice is increasing, and length of hospice stay decreasing.
Researchers at Brigham and Women’s Hospital (BWH) examined how hospice affects health care utilization and costs and found that in a sample of elderly Medicare patients with advanced cancer, hospice care was associated with significantly lower rates of both health care utilization and total costs during the last year of life. Ultimately, those who chose hospice were five times less likely to die in hospitals and nursing homes.