Doctors Can Influence End-of-Life Care
Terminally ill patients of physicians who frequently refer to hospice more likely to choose it, study says
MONDAY, June 8, 2015 (HealthDay News) -- Doctors appear to have a strong influence on whether or not dying patients enroll in hospice care, a new study finds.
Researchers reviewed information on nearly 199,000 cancer patients in the United States who were eligible for hospice care because they were dying. The average age was 78. The information was gathered between 2006 and 2011.
Two-thirds enrolled in hospice care. Those who chose hospice were more likely to be women, white and to live in higher income areas.
The investigators found that patients were more likely to enroll in hospice care if their doctor had a high number of patients in hospice care.
The researchers accounted for patient, hospital and geographic factors associated with hospice care. They found that patients were 27 percent more likely to enroll in hospice care if their doctor was in the top 10 percent of doctors using hospice care compared to patients whose doctors were in the bottom 10 percent.
However, while the study found an association between a doctor's use of hospice and their patients' choice, it couldn't prove a cause-and-effect relationship.
"We found that the physician a patient sees is the single most important predictor we know of whether or not that patient enrolls in hospice care," study author Dr. Ziad Obermeyer, a physician researcher in the department of emergency medicine at Brigham and Women's Hospital in Boston, said in a hospital news release.
"This new information provides a clear policy target for improving and advancing the quality of care for patients at the end of their lives," he added.
The researchers also found that a large number of patients in the study were seen by a small group of doctors.
"Our data show that about 10 percent of physicians cared for about half of all patients. This suggests that we can target a small group of physicians with interventions geared towards physician specialty and how often their patients enroll in hospice to improve end of life care," Obermeyer said.
The study was published in the June issue of the journal Health Affairs.
The American Academy of Family Physicians has more about hospice care.