Heart Failure Patients Enrolled in Hospice Use Less Health Care
Fewer ED visits, hospital stays, and ICU stays; longer median survival for those enrolled in hospice
MONDAY, Sept. 24, 2018 (HealthDay News) -- Patients with advanced heart failure enrolled in hospice have fewer emergency department visits, hospital days, and intensive care unit (ICU) stays, according to a study published in the September issue of JACC: Heart Failure.
Laura P. Gelfman, M.D., M.P.H., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues used a propensity-score matched sample of Medicare decedents with two or more heart failure discharges within six months to identify predictors of hospice enrollment for heart failure patients and to compare hospitalizations, ICU stays, and emergency department visits for those enrolled and not enrolled in hospice. A total of 3,067 beneficiaries were in each group, with a mean age of 82 years.
The researchers observed no differences in the characteristics, symptom burden, or functional status between the groups that were associated with enrollment in hospice. The hospice group had significantly fewer emergency department visits (2.64 versus 2.82), hospital days (3.9 versus 4.67), and ICU stays (1.25 versus 1.51) in the six months after the second heart failure discharge; they were also significantly less likely to die in the hospital (3 versus 56 percent) and had longer median survival (80 versus 71 days).
"A tailored hospice model may be needed to increase enrollment and offer benefits to a heart failure population," the authors write.