This is for our readers who treat terminal pain patients.
Patients with poor-prognosis cancer who enter hospice use less intensive medical care and incur lower costs, compared with patients who don’t receive hospice, according to a retrospective JAMA study.
Researchers studied Medicare beneficiaries who had a poor-prognosis cancer and died in 2011. Nearly 20,000 beneficiaries who entered hospice were matched with similar beneficiaries who didn’t use hospice. The median hospice duration was 11 days.
Hospice patients were less likely to be hospitalized (42% vs. 65% of non-hospice beneficiaries), be admitted to the ICU (15% vs. 36%), or undergo invasive procedures (27% vs. 51%). In addition, total costs in the last year of life were about $9000 lower per hospice patient ($63,000 vs. $72,000).
The authors conclude: “Our findings highlight the potential importance of frank discussions between physicians and patients about the realities of care at the end of life, an issue of particular importance as the Medicare administration weighs decisions around reimbursing physicians for advance care planning.”