An Age Group Comparison of Concurrent Hospice Care: A Cost-Effectiveness Analysis.
Radion Svynarenko, Melanie J Cozad, Lisa C Lindley
PMID 38748541WHAT IT FOUND
For children enrolled in Medicaid hospice, concurrent care avoided more live discharges but cost more.
The trade-off was most favorable for infants and children under 5, where added cost for each 1% reduction in live discharge was lowest.
Key findings
01Concurrent hospice care reduced live discharges in all four age groups but had higher Medicaid cost than standard care.
02The added Medicaid cost per 1% decrease in live discharge was $45 for children under 1 and $49 for ages 1 to 5, compared with $217 for ages 6 to 14 and $107 for ages 15 to 20.
03Incremental Medicaid cost of concurrent care was $785 per patient per month for ages 1 to 5, $1481 for under 1, $1796 for ages 15 to 20, and $3217 for ages 6 to 14.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis used administrative Medicaid data from 2011 to 2013, early in implementation, so it may not reflect current hospice practice. It included only children enrolled in Medicaid, so results may not apply to families with private insurance. Live discharge was defined as two or more hospice enrollments, which may miss children who left hospice without readmission. It measured costs and live discharge, not comfort, family satisfaction, or survival. The authors did not investigate factors that contribute to cost-effectiveness.
Declared interests
The paper is listed as supported by NIH extramural research. No conflicts-of-interest statement is included in the supplied article text.
The easy way to misread this
Do not read this as proof that concurrent hospice care saves money or improves clinical outcomes. It reduced live discharges in administrative Medicaid data, but costs were higher, and the study did not measure comfort, family satisfaction, or survival.