Hospice Care Patients Received Less Aggressive Treatment

Non hospice patients were hospitalized more often than hospice patients and underwent more invasive procedures

(RxWiki News) Patients with terminal diseases like cancer have been opting for end-of-life hospice care more than ever. New research found that this decision could significantly affect their treatment and health outcomes.

The authors of a new study looked at data from cancer patients near the end of life.

Comparing those who chose hospice care to those who didn't, they found that non-hospice patients received far more aggressive care.

That care was mostly "related to acute complications like infections and organ failure, and not directly related to their cancer diagnosis," said lead author Ziad Obermeyer, MD, of Brigham and Women's Hospital, in a press release.

Non-hospice patients were also hospitalized more often and were more likely to die at a hospital or nursing home, rather than at home.

Hospice, or end-of-life care, focuses on making patients as comfortable and pain-free as possible, rather than treating or curing a disease. Past research has suggested that continuing treatment toward the end of life may be counterproductive and lead to poorer health outcomes.

The current study looked at cancer patients using Medicare, which is government-sponsored health insurance for seniors. Dr. Obermeyer and team examined whether hospice patients had fewer hospitalizations and invasive procedures than non-hospice patients.

Among almost 87,000 of these patients in 2011, about 60 percent entered hospice care before they died. The study authors selected a group of about 18,000 of these hospice patients and compared them to a similar group who did not enter hospice before death.

They found that non-hospice patients had about twice as many intensive-care admissions as hospice patients. About 27 percent of these hospice patients had to undergo an invasive procedure — compared with more than half of non-hospice patients.

Non-hospice patients were also hospitalized more frequently than hospice patients.

Also, 74 percent of non-hospice patients died in a hospital or nursing home, compared to only 14 percent of hospice patients.

"Our study shows very clearly that hospice matters," Dr. Obermeyer said. "Patients who didn't enroll in hospice ended up with far more aggressive care in their last year of life."

The study was published Nov. 11 in JAMA.

The National Institutes of Health, the National Cancer Institute and the Agency for Healthcare Research and Quality funded the research. The authors declared no conflicts of interest.


Review Date: 
November 11, 2014