Medicare hospice care in US nursing homes: a 2006 update

Abstract

Introduction: This research examines 2006 population-based data on persons who died in US nursing homes (NHs) and received hospice in the NH.

Methods: We compared dying persons characteristics and lengths of hospice stay in five US states between 1992 and 1996 and in 2006. We also compared characteristics of dying persons in 2006 by whether they first entered hospice in the community (i.e. 'community-NH', N=12,950) or the NH (i.e. 'NH-only', N=159,065).

Results: In five US states, dying persons who received NH hospice in 2006, compared to 1992-1996, were older, had more short hospice stays (≤7 days), and were less frequently diagnosed with cancer. Also, in 2006, dying persons receiving 'NH-only' versus 'community-NH' hospice were older, had more short stays, and were less frequently diagnosed with cancer.

Discussion: Persons in 2006 who received hospice in the community and in the NH (vs. 'NH-only') were strikingly similar to hospice participants in 1992-1996. 2006 'NH-only' vs. 'community-NH' dying persons, more closely resemble U.S. NH residents.

Figure 1

Length of stay of nursing home dying persons who received hospice in five US states.

Figure 2

Length of stay of nursing home decedents according to type of admission into hospice on full US population in 2006^a. ^aDifferences are statistically significant at the p <0.001 level using the Chi-square statistic and t-tests. ^b‘Post’ refers to nursing home residents who did not receive hospice prior to being a resident and only received it when enrolled in the nursing home. ‘Crossover’ refers to nursing home residents who received hospice prior to moving into the nursing home and also received it while in the nursing home. NH: nursing home.