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Hospice a Seldom Used Option in Heart Failure Patients

Only 1.6 percent in sample went from hospital to hospice; referred patients more likely to be older

TUESDAY, Oct. 9 (HealthDay News) -- Although a number of consensus statements and guidelines support palliative care for patients with advanced heart failure, only a small number of patients admitted to acute care hospitals for decompensated heart failure are referred to hospice, according to research published in the Oct. 8 issue of the Archives of Internal Medicine.

Paul J. Hauptman, M.D., of the Saint Louis University School of Medicine, and colleagues analyzed data on 182,898 episodes of acute decompensated heart failure from 307 hospitals in order to assess patient and hospital variables associated with hospice referral.

The investigators found that only 1.6 percent of patients were referred to hospice. Hospitals that most commonly referred patients to hospice adhered to quality indicators for heart failure at least as well as hospitals that were least likely to refer patients to hospice, indicating that patients weren't discharged excessively early.

"Several publications have proposed indications for hospice referral in patients with heart failure. Hospice care under Medicare is appropriate for patients deemed to have a likely six-month life expectancy by their physician and the hospice medical director. Guidelines for hospice referral recommend that the patient should demonstrate severe limiting symptoms and poor prognosis despite optimal medical therapy or documentation of intolerance to therapy," the authors write.

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