Healthcare costs rise for cancer patients
Healthcare costs rise for cancer patients
Stopping hospice increases expenses
Cancer patients who stop hospice care are far more likely to use expensive medical services, such as emergency care and hospitalization. Use of these services leads to healthcare costs that are nearly five times higher for patients who disenroll from hospice care compared to patients who remain in hospice, according to a study published in Journal of Clinical Oncology.1
Authors also found a higher than expected rate of disenrollment. More than 1 in 10 patients with terminal cancer (nearly 11%) who enrolled in hospice care ended up leaving. Reasons for disenrollment were not evaluated in the study.
Cancer patients who disenrolled from hospice care were more likely to be hospitalized (39.8% vs 1.6%), more likely to seek emergency care (33.9% vs 3.1%), more likely to be admitted to the intensive care unit (5.7% vs 0.1%), and more likely to die in the hospital (9.6% vs 0.2%).
Cancer patients represent the largest diagnostic group of hospice users. In the United States, 560,000 cancer patients were referred for hospice care in 2008. Previous research indicates that 11% to 15% of hospice patients disenroll from hospice care, the authors say. Factors such as being younger, not being white, being male, and having a diagnosis other than cancer are associated with hospice withdrawal, they note.
Researchers analyzed data from 90,826 patients who died with a primary diagnosis of cancer between 1998 and 2002 at 66 years of age or older. All patients used hospice services at some point in the six months before their death.
A total of 9,936 patients (10.9%) disenrolled from hospice care before they died, with a median of 28 days from hospice enrollment to disenrollment. More than half (57%) of patients who disenrolled died within 30 days. The authors also noted a pattern of enrollment, disenrollment, and re-enrollment in more than one-third (38%) of patients. Those who re-enrolled died a median of 24 days after re-enrollment.
Reference:
1. Carlson MDA, Herrin J, Du Q, et al. Impact of hospice disenrollment on health care use and Medicare expenditures for patients with cancer. J Clin Onc 2010:4371-4375.
Cancer patients who stop hospice care are far more likely to use expensive medical services, such as emergency care and hospitalization. Use of these services leads to healthcare costs that are nearly five times higher for patients who disenroll from hospice care compared to patients who remain in hospice, according to a study published in Journal of Clinical Oncology.Subscribe Now for Access
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