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Researchers find disparities in hospice discharge outcomes




Researchers find disparities in hospice discharge outcomes

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Black patients leaving hospice care and patients with short stays in hospice care are at increased risk of being hospitalized after being discharged from hospice, according to researchers at Rutgers Health.

Their studypublished in JAMA network openedexamined patient outcomes after discharge from hospice care to determine which factors contribute to transitions that lead to negative health outcomes.

“Hospice care teams may want to pay particular attention to the discharge planning needs of racial and ethnic minority patients and patients with more complicated needs,” said Elizabeth Luth, lead author of the study and a core faculty member at the Center for Health. Research into healthy aging at the Rutgers Institute for Health, Health Care Policy and Aging Research.

Approximately 15% of patients leave hospice care before death for a number of reasons, including unplanned hospitalization, seeking treatment for a terminal condition, transfer of hospice services, or stabilization of condition. The transition to another care setting is often stressful for the patient’s health.

According to researchers, the factors that contribute to the risk of burdensome transitions out of hospice care are understudied but are important for physicians and policy makers to better understand.

Using Medicare data from more than 115,000 patients between 2014 and 2019, researchers looked at several types of burdensome transitions out of hospice care, including patients who were admitted to a hospital after leaving care and patients who died while in the hospital. were admitted to hospital. They sought to assess which individual patients, health care services, and hospice organizational factors are associated with different types of transition outcomes.

Researchers found that black patients who had shorter hospice stays and received care from a for-profit hospice were more likely to have a burdensome transition after being discharged. About 42% of hospice patients who are discharged die within six months, “suggesting that uninterrupted hospice care may be appropriate for many people who are discharged,” the researchers found.

Inequitable access to health care services, as well as institutionalized racism, are major factors in racial and ethnic disparities in health outcomes, according to previous research published in The New England Journal of Medicine And The Lancet.

Researchers also found that inpatient respite (services that provide short-term relief to caregivers) and general inpatient care (short-term hospital care for symptom management) were associated with lower odds of hospitalization and hospice readmission.

“Policymakers may consider making inpatient respite care and general inpatient care more widely available and accessible to families with hospice members with complex needs to support better outcomes when they are discharged,” said Luth, assistant professor in the Department of Family Affairs. Medicine and Community Health at Rutgers Robert Wood Johnson Medical School.

Co-authors of the study include Caitlin Brennan and Susan Hurley of Care Dimensions, a hospice and palliative care organization in Massachusetts, Veerawat Phongtankuel, Holly Prigerson and Yongkang Zhang of Weill Cornell Medicine, Miriam Ryvicker of VNS Health, a nonprofit community health organization in New York City, and Hui Shao of Emory University.

More information:
Elizabeth A. Luth et al, Readmission, Hospitalization, and In-Hospital Death Among Patients Discharged Alive from Hospice, JAMA network opened (2024). DOI: 10.1001/jamanetworkopen.2024.11520

Provided by Rutgers University

Quote: Researchers Find Disparities in Hospice Discharge Outcomes (2024, June 18), Retrieved June 19, 2024 from

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