Study Finds Hospice Programs Lag in Last Days of Life – Especially for Blacks

Share Article

A new study published in JAMA Internal Medicine finds racial disparity in hospice care: blacks are 30 percent less likely to receive visits from hospice staff in the last two days of life. The study, co-authored by researchers at Abt Associates, also found that 8 percent of hospice programs made no visits in the last days of a patient’s life.

A new study reveals a racial disparity in hospice care: blacks are 30 percent less likely to receive visits from hospice staff in the last two days of life. The study also found that 8 percent of hospice programs made no visits in the last days of a patient’s life. The study was published in JAMA Internal Medicine.

Hospice programs provide home visits by physicians, nurses, or social workers, medications, and durable medical equipment – supports that family caregivers typically could not provide. Since symptoms worsen in the last days of life, patients and family caregivers often need medical care, information, and emotional support by hospice staff. This care is necessary to ensure the patient will die comfortably.

The study looked at variations in Medicare-funded hospice services in the last two days of life. The day of death was a strong predictor of whether a patient received a hospice visit in the last two days of life – those dying on Sunday are three times more likely not to receive a visit compared to those who die on Tuesday.

The study also found that larger, well-established hospice providers were more likely to provide more visits in the final days of life. Where you live also plays a role – those living in Alaska, Washington, New Jersey, and Rhode Island while receiving hospice care, are the most likely to not receive visits in the last days.

“These findings provide good insight into where the provision of hospice services is lacking and where the disparities exist,” said Dr. Michael Plotzke, Senior Associate at Abt Associates and co-author of the study. “Especially in the final days of life when physical and emotional needs are great, patients and family caregivers should have the much needed support of the hospice.”

The study, funded by the Centers for Medicare & Medicaid Services, provides meaningful insight on factors associated with patients and families that do not receive the services and supports that they need at such a vulnerable time. This is especially important to consider as the agency recently finalized payment reform policies that include increased payment for the first 60 days of hospice care and a service intensity add-on that provides additional payment under certain circumstances if the hospices provides visits to the patient in the last week of life.

Co-authors of the study include Dr. Thomas Christian, Ph.D. of Abt Associates, Dr. Joan M. Teno, M.D., M.S. with the University of Washington, and Dr. Pedro Gozalo, Ph.D. of Brown University.

About Abt Associates
Abt Associates is a mission-driven, global leader in research, evaluation and program implementation in the fields of health, social and environmental policy, and international development. Known for its rigorous approach to solving complex challenges, Abt Associates is regularly ranked as one of the top 20 global research firms and one of the top 40 international development innovators. The company has multiple offices in the U.S. and program offices in more than 40 countries. http://www.abtassociates.com

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Caroline Broder
Abt Associates
+1 3013475792
Email >