Cancer Patients in Hospice Face Less Aggressive Treatment: Study
More health care strategies and costs seen for non-hospice patients at end of life
TUESDAY, Nov. 11, 2014 (HealthDay News) -- Cancer patients who choose hospice care are less likely to receive aggressive end-of-life treatment or to die in hospitals and nursing homes, a new study finds.
Researchers studied more than 18,100 elderly Medicare patients who had advanced cancer and received hospice care, and compared them with the same number of patients who did not receive hospice care.
Non-hospice patients used significantly more health care resources, such as hospitalization, intensive care and invasive procedures, largely for acute conditions not directly related to their cancer.
Seventy-four percent of non-hospice patients died in hospitals or nursing homes, compared with 14 percent of hospice patients.
And over the last year of life, the health care costs for non-hospice patients averaged $71,517 compared to $62,819 for hospice patients, according to the results published in the Nov. 12 issue of the Journal of the American Medical Association.
"Our study shows very clearly that hospice matters. Hospice and non-hospice patients had very similar patterns of health care utilization, right up until the week of hospice enrollment -- then the care started to look very different," study leader Dr. Ziad Obermeyer, from the department of emergency medicine at Brigham and Women's Hospital in Boston, said in a hospital news release.
"Patients who didn't enroll in hospice ended up with far more aggressive care in their last year of life -- most of it related to acute complications like infections and organ failure, and not directly related to their cancer diagnosis," he noted.
"These findings highlight the importance of honest discussions between doctors and patients about our patients' goals of their care at the end of life, relating to treatment decisions and quality of life," said Obermeyer, who is also an assistant professor of emergency medicine and health care policy at Harvard Medical School.
"This is of particular importance now, in light of the ongoing policy discussions around reimbursing providers for advance care planning," he added.
The American Academy of Family Physicians has more about hospice care.