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Death and dying 2000-2009: Hospice Use Rises; So Does Aggressive Care

By Guest PostFebruary 14, 2013General, Healthadd-on, aggressive care, brown university, chronic, data, david goodman, death and dying, dying seniors, end of life, hospice use, icu utilization, joan teno, medical centers, obstructive pulmonary disease, pedro gozalo, physician culture, poor communication, regional differences, repeat hospitalizations, research team, susan miller, thomas scupp, trajectory

A study in the Journal of the American Medical Association documents an increase in hospice use over the last decade but also finds more ICU utilization, more repeat hospitalizations, and more late health care transitions. The data raises concern about whether aggressive care and burdensome transitions at the end of life are consistent with the wishes of patients or those of their family members.

PROVIDENCE, R.I. [Brown University] — A study published Feb. 6 in the Journal of the American Medical Association finds that while more seniors are dying with hospice care than a decade ago, they are increasingly doing so for very few days right after being in intensive care. The story told by the data, said the study’s lead author, is that for many seniors palliative care happens only as an afterthought. (more…)

Medicare Policy: Barrier to Hospice Increases Hospitalization

By Guest PostOctober 31, 2012Healthadvanced dementia, affordable, aggressive treatment, analysis, antianxiety drugs, brown university, care act, death, hospice care, hospitalization, hypnotic, iv fluids, julie lima, medicare policy, medicare reimbursement, nursing home, physical therapy, skilled nursing, snf, susan miller, susan mitchell

Because of a Medicare policy that prevents simultaneous reimbursement for skilled nursing and hospice care, many families cannot choose hospice for loved ones who reside in nursing homes. The result, new research shows, is that residents with advanced dementia who have Medicare skilled nursing home care without any hospice care have a far greater likelihood of dying in the hospital and receiving aggressive treatments such as feeding tubes or physical therapy within weeks of death.

PROVIDENCE, R.I. [Brown University] — A Medicare rule that blocks thousands of nursing home residents from receiving simultaneous reimbursement for hospice and skilled nursing facility (SNF) care at the end of life may result in those residents receiving more aggressive treatment and hospitalization, according a new analysis.

“This study is the first, to the knowledge of the authors, to attempt to understand how treatments and outcomes vary for nursing home residents with advanced dementia who use Medicare SNF care near the end of life and who do or do not enroll in Medicare hospice,” wrote researchers, including lead author Susan Miller, research professor of health services policy and practice at Brown University, in the Journal of the American Geriatrics Society. (more…)

Tag Archives: susan miller

Death and dying 2000-2009: Hospice Use Rises; So Does Aggressive Care

Medicare Policy: Barrier to Hospice Increases Hospitalization