New hospice facts and figures

Report reveals drop in length of service

The National Hospice and Palliative Care Organization's (NHPCO) annual report, Facts and figures: hospice care in America, shows the number of patients served remains fairly constant at 1.58 million in 2010 (a slight rise from 1.56 million served in 2009). Yet a statistic of concern to hospice and palliative care professionals is the drop in median and average length of service.

The median (50th percentile) length of service in 2010 was 19.7 days, a decrease from 21.1 days in 2009. The average length of service dropped to 67.4 days in 2010 from 69 days in 2009.

"What's important to recognize here is that half of hospice patients received care for less than 20 days," says J. Donald Schumacher, NHPCO president and CEO. "With drops in both the median and average length of service, there is concern that hospice providers are not reaching the patients and family caregivers who need hospice support in a timely manner."

Schumacher says that while Medicare's coverage of hospice has risen in the past decade, it represents appropriate care of dying Americans. What isn't wanted is for appropriate access of hospice care to drop, particularly with the aging population where more people are dying with complex, multiple illnesses. "There are no better providers more skilled at providing palliative care at the end of life than hospice professionals, and the dying deserve the best care that our society can offer," he says.

In previous decades, hospices overwhelmingly cared for people with cancer. In 2010, cancer diagnoses dropped to 35.6% from 40.1% in 2009. At 14.3%, heart disease, which is the leading cause of death in the United States, is the leading non-cancer diagnosis among hospice patients.

In 2010, about 35.3% of patients died or were discharged within seven days of admission (a slight increase compared to 34.3% in 2009). Almost the exact same proportion of patients remained under hospice care for longer than 180 days (11.8% in 2009 and 2010).

"It's very difficult for patients and families to take full advantage of the range of services hospice offers when they are under care for only a few days. We must be careful about focusing too intently on long-stay patients while turning a blind eye to the large number of patients dying in less than a week," stated Schumacher.

Two new additions to the new edition of the report include sections looking at hospice care within the Medicare population and within the nursing home. An appendix geared for academics examining the accuracy of NHPCO's national figures also has been added.