Are Trends in Hospitalization Prior to Hospice Use Associated With Hospice Episode Characteristics?

The sample came from four communities and was not nationally representative; only 13% were older than 85 years, compared with about 40% of hospice users in the United States. The study did not include people who did not use hospice, so it cannot show why hospital trends led to short stays or live discharge. It looked only at Medicare hospice claims and excluded Medicaid, Veterans Administration, and private hospice use. The trend analysis excluded 290 participants with no hospitalizations, so findings about hospital-use trends apply only to those who had at least one admission. Caregiver availability and other potentially important factors were not measured. The fee-for-service subgroup was smaller (791), and nursing-home measures differed, so some subgroup estimates were not significant. Race and community were linked to hospice outcomes, which may reflect local hospice availability rather than individual care patterns.

The authors declared no potential conflicts of interest with respect to the research, authorship, or publication.

Do not conclude that cutting hospital admissions would lengthen hospice stays or prevent live discharge. The study is observational, did not compare people who did not use hospice, and did not test any intervention.