MHA Press Room

Study: More Americans using hospice care at end of life

More elderly Medicare patients are receiving hospice care when they die, and fewer are in the hospital, according to a study in this week’s Journal of the American Medical Association. Among Medicare patients age 66 and older, use of hospice care at the time of death increased from 22% in 2000 to 42% in 2009 while acute care hospital use decreased from 33% to 25%, the study found.

However, the proportion of older Medicare patients with an ICU stay in the last month of life also increased, from 24% to 29%. “Our findings of an increase in the number of short hospice stays following a hospitalization, often involving an ICU stay, suggest that increasing hospice use may not lead to a reduction in resource utilization,” the authors said.

Minorities less likely to use hospice care, study says

Far fewer minorities use hospice care for terminal illness compared with whites, according to a study released by the California HealthCare Foundation, an Oakland-based philanthropy.

Citing 2004 data of patients who died while receiving services, the researchers found:

• 74% were white
• 4% were Asian American
• 6% were African American
• 15% were Latino

The study concluded that the requirements for hospice enrollment can conflict with the preferences of patients such as African Americans and Latinos, who might not want to forego acute therapies not covered by Medicare's hospice benefit.

To help combat the disproportionate number of minorities using hospice, the authors recommend reforming the Medicare Hospice Benefit to allow for more aggressive treatments along with palliative care.

Sources: The Los Angeles Times; California Heathline, Case Management Weekly