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Hospice cost fluctuates during length of service
Hospice care can improve symptom management and quality of life for patients, but intensity and cost of care varies from patient to patient, depending on the length of service, according to a study in Inquiry.1
Costs are higher at the beginning of service due to staff time needed to set up the admission and plan of care, and time needed to arrange for medical equipment, supplies, and medications. However, costs drop after the initial three days of care. Nursing visits, equipment or medication changes, and assessments continue throughout the length of service, but it is not until the patient nears the end of life that costs rise again. This increase is due to intense, round-the-clock care needed to provide symptom and pain management, as well as family support.
The study does point out that hospice costs are lower for nursing home patients due to the overlap of nursing home and hospice services. The authors recommend a downward adjustment of the hospice per diem for patients in a nursing home.
1. Huskamp HA, Newhouse JP, Norcini JC, et al. Variation in hospice patients' costs. Inquiry 2008; 45:232-244. t