Hospice facilities can help reduce end-of-life hospitalizations by asking dying patients when they are admitted where they want to die and by monitoring their symptoms often, according to new research from the Icahn School of Medicine at Mount Sinai in New York.
The study was published in the journal Medical Care.
The authors of the study examined National Hospice Survey data for 149,814 Medicare beneficiaries at a random sample of 577 U.S. hospices. The researchers tracked the beneficiaries from between 2008 and 2011 until their death. They also focused their research on six hospice patient care practices.
Of the six preferred hospice practices the researchers analyzed, only two — asking about patient preferences for site of death at admission and frequently monitoring symptoms — were associated with a substantial decrease in hospital deaths and emergency department visits.
The study also found for-profit hospices have consistently high rates of hospitalization regardless of preferred hospice practice implementation.
"Our results highlight the need to better understand the practices of for-profit hospices where the pattern of high hospitalization of patients is persistent," according to study author Melissa Aldridge, PhD. "Our data also suggests that the hospitalization of individuals who had enrolled with for-profit hospices may be a means of shifting costs of care from the hospice organization to Medicare, but more research is necessary to explore this issue."
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