Association Between Nursing Visits and Hospital-Related Disenrollment in the Home Hospice Population

Background: Over 10% of hospice patients experience a transition out of hospice care during the last months of life. Hospice transitions from home to hospital (ie, hospital-related hospice disenrollment) result in fragmented care, which can be burdensome for patients and caregivers. Nurses play a ma...

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Bibliographic Details
Published in:American journal of hospice & palliative medicine 2018-02, Vol.35 (2), p.316-323
Main Authors: Phongtankuel, Veerawat, Adelman, Ronald D., Trevino, Kelly, Abramson, Erika, Johnson, Phyllis, Oromendia, Clara, Henderson, Charles R., Reid, M. C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Female
Home Care Services - statistics & numerical data
Hospice Care - statistics & numerical data
Hospitalization - statistics & numerical data
Humans
Male
Medicare - statistics & numerical data
Middle Aged
Nurses, Community Health - statistics & numerical data
Retrospective Studies
Socioeconomic Factors
United States
Young Adult
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Summary:Background: Over 10% of hospice patients experience a transition out of hospice care during the last months of life. Hospice transitions from home to hospital (ie, hospital-related hospice disenrollment) result in fragmented care, which can be burdensome for patients and caregivers. Nurses play a major role in delivering home hospice care, yet little is known about the association between nursing visits and disenrollment. Objectives: The study’s purpose is to examine the association between the average number of nursing visits per week and hospital-related disenrollment in the home hospice population. We hypothesize that more nursing visits per week will be associated with reduced odds for disenrollment. Design: A retrospective cohort study using Medicare data. Participants: Medicare hospice beneficiaries who were ≥18 years old in 2012. Outcome measured: Hospitalization within 2 days of hospice disenrollment. Results: The sample included 115 103 home hospice patients, 6450 (5.6%) of whom experienced a hospital-related disenrollment. The median number of nursing visits per week was 2 (interquartile range 1.3-3.2), with a mean of 2.5 (standard deviation ±1.6). There was a decreased likelihood of a hospital-related disenrollment when comparing enrollments that had
ISSN:1049-9091
1938-2715
DOI:10.1177/1049909117697933