Impact of Length of Hospice on Spending and Utilization Among Medicare Beneficiaries With Lung Cancer
OBJECTIVES: To estimate differences in spending and utilization between hospice users and non-users with lung cancer by length of hospice enrollment.
STUDY DESIGN: Retrospective analysis using 2009-2013 Medicare claims.
METHODS: The study sample was a 10% random sample of Medicare fee-for-service beneficiaries with lung cancer who died between 2010 and 2013. We identified different categories of hospice users (hospice enrollment for 1-7 days, 8-14 days, 15-30 days, 31-60 days, 61 days - 6 months) and non-users. We used propensity score matching to match users in each enrollment category with non-users. The outcomes were: a) total Medicare spending, b) number of hospitalizations, c) number of emergency department (ED) visits, d) number of physician-administered chemotherapy claims, and e) number of radiation therapy sessions. Regression analysis was used to compare outcomes between users and non-users by enrollment period.
RESULTS: Hospice users had significantly lower spending, fewer hospitalizations, and fewer ED visits than non-users across all categories of hospice enrollment. Large savings occurred when patients stayed in hospice for at least one month (US$16,566 for those enrolled 61 days - 6 months; US$16,409 for those enrolled 31-60 days). Significant reduction in use of outpatient services including chemotherapy and radiation therapy was observed among patients using hospice for at least 1 month.
CONCLUSIONS: Hospice led to cost savings by reducing utilization of aggressive care towards end-of-life among lung cancer patients. While cost savings were realized even when hospice is utilized for a short duration, large savings occurred when hospice is used for at least 1 month.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
|---|---|
| Enthalten in: |
The American journal of hospice & palliative care - 37(2020), 11 vom: 16. Nov., Seite 918-924 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Kalidindi, Yamini [VerfasserIn] |
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| Links: |
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| Themen: |
End-of-life |
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| Anmerkungen: |
Date Completed 28.07.2021 Date Revised 16.04.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/1049909120909304 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM307161021 |
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| 500 | |a Date Revised 16.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: To estimate differences in spending and utilization between hospice users and non-users with lung cancer by length of hospice enrollment | ||
| 520 | |a STUDY DESIGN: Retrospective analysis using 2009-2013 Medicare claims | ||
| 520 | |a METHODS: The study sample was a 10% random sample of Medicare fee-for-service beneficiaries with lung cancer who died between 2010 and 2013. We identified different categories of hospice users (hospice enrollment for 1-7 days, 8-14 days, 15-30 days, 31-60 days, 61 days - 6 months) and non-users. We used propensity score matching to match users in each enrollment category with non-users. The outcomes were: a) total Medicare spending, b) number of hospitalizations, c) number of emergency department (ED) visits, d) number of physician-administered chemotherapy claims, and e) number of radiation therapy sessions. Regression analysis was used to compare outcomes between users and non-users by enrollment period | ||
| 520 | |a RESULTS: Hospice users had significantly lower spending, fewer hospitalizations, and fewer ED visits than non-users across all categories of hospice enrollment. Large savings occurred when patients stayed in hospice for at least one month (US$16,566 for those enrolled 61 days - 6 months; US$16,409 for those enrolled 31-60 days). Significant reduction in use of outpatient services including chemotherapy and radiation therapy was observed among patients using hospice for at least 1 month | ||
| 520 | |a CONCLUSIONS: Hospice led to cost savings by reducing utilization of aggressive care towards end-of-life among lung cancer patients. While cost savings were realized even when hospice is utilized for a short duration, large savings occurred when hospice is used for at least 1 month | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a length of hospice | |
| 650 | 4 | |a lung cancer | |
| 700 | 1 | |a Jung, Jeah |e verfasserin |4 aut | |
| 700 | 1 | |a Segel, Joel |e verfasserin |4 aut | |
| 700 | 1 | |a Leslie, Douglas |e verfasserin |4 aut | |
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