Risk Factors for Hospitalization of Home Hospice Enrollees Development and Validation of a Predictive Tool.
Veerawat Phongtankuel, P Johnson, M C Reid and 4 others
PMID 27448668WHAT IT FOUND
In home hospice patients, younger age, Black or non-Black minority, and 4 or more chronic conditions were associated with higher hospitalization risk.
In the development set, a score of 18 or more flagged 5 percent of enrollments, but only 22% were hospitalized.
Key findings
01Patients with 4 or more chronic conditions had greater odds of hospitalization than patients with 0 or 1 chronic condition.
02Younger age, Black race, and non-Black minority race were each associated with greater odds of hospitalization compared with White patients.
03In the development set, a score of 18 or more captured 5 percent of enrollments, and 22% of those captured were hospitalized.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used Medicare claims data, so it could not capture care preferences, psychosocial influences, caregiver variables, acute symptoms, or reasons for hospitalization. It could not identify observational stays or emergency room visits. The study reported 384,484 enrollments in the cohort and 123,894 enrollments in the final analysis. It did not have details about hospice size or practice patterns, which may influence hospitalization. The model was developed and validated within the same 2012 Medicare claims cohort. In the development set, a score of 18 or more captured 5 percent of enrollments, and 22% of those captured were hospitalized. The findings show associations, not causes. The study did not test whether using the score or adding services reduced hospitalization.
Declared interests
The supplied text does not report funding or conflicts of interest.
The easy way to misread this
Do not read a score of 18 or more as meaning a patient will probably be hospitalized. In the development set, only 22% of those flagged were hospitalized, and the study did not test whether extra services changed that outcome.