A National Study of Live Hospice Discharges between 2000 and 2012

Elizabeth Prsic, Mike Plotzke, Thomas J. Christian, Pedro Gozalo, Joan Teno

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Live hospice discharges represent a potential vulnerability in the Medicare hospice benefit. Little is known about how live discharges have varied over time. Objective: To identify trends in live hospice discharges between 2000 and 2012. Design, Setting, Patients: Retrospective cohort study of Medicare hospice discharges. Measurements: In this study, we examined live discharges in the first six months of 2000, 2006, 2008, 2010, and 2012. A live discharge was classified as a burdensome transition if hospice discharge was followed by hospital admission, and then there was a hospice readmission within 2 days of hospital discharge. The adjusted rate of overall live discharges and burdensome transitions was examined with a multivariate mixed-effects logistic model that adjusted for age, gender, race, and hospice primary diagnosis. The model contained an interaction term for year and hospice tax status. Results: The unadjusted overall rate of live discharges increased from 13.7% in 2000 to 18.1% in 2012. For-profit hospice programs had an adjusted live discharge rate of 17.7% in 2000 and 22.7% in 2012. During the same period, the adjusted live discharge rate for nonprofit hospice programs increased from 15.2% to 16.3%. The overall rate of burdensome transitions increased from 2.9% in 2000 to 5.3% in 2012. Similar to the overall rate of live discharge, for-profit hospices had a higher rate of burdensome transitions (6.4%) than nonprofit hospices (4.0%) in 2012. Conclusions: Live hospice discharges and burdensome transitions increased between 2000 and 2012. For-profit hospice programs demonstrated larger increases than nonprofit hospice programs.

Original languageEnglish (US)
Pages (from-to)987-990
Number of pages4
JournalJournal of palliative medicine
Volume19
Issue number9
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

Fingerprint

Hospices
Hospice Care
Medicare
Taxes
Cohort Studies
Retrospective Studies
Logistic Models

ASJC Scopus subject areas

  • Nursing(all)
  • Anesthesiology and Pain Medicine

Cite this

A National Study of Live Hospice Discharges between 2000 and 2012. / Prsic, Elizabeth; Plotzke, Mike; Christian, Thomas J.; Gozalo, Pedro; Teno, Joan.

In: Journal of palliative medicine, Vol. 19, No. 9, 01.09.2016, p. 987-990.

Research output: Contribution to journalArticle

Prsic, Elizabeth ; Plotzke, Mike ; Christian, Thomas J. ; Gozalo, Pedro ; Teno, Joan. / A National Study of Live Hospice Discharges between 2000 and 2012. In: Journal of palliative medicine. 2016 ; Vol. 19, No. 9. pp. 987-990.
@article{cfb9e98a231f404ebcf30ac011f54a88,
title = "A National Study of Live Hospice Discharges between 2000 and 2012",
abstract = "Background: Live hospice discharges represent a potential vulnerability in the Medicare hospice benefit. Little is known about how live discharges have varied over time. Objective: To identify trends in live hospice discharges between 2000 and 2012. Design, Setting, Patients: Retrospective cohort study of Medicare hospice discharges. Measurements: In this study, we examined live discharges in the first six months of 2000, 2006, 2008, 2010, and 2012. A live discharge was classified as a burdensome transition if hospice discharge was followed by hospital admission, and then there was a hospice readmission within 2 days of hospital discharge. The adjusted rate of overall live discharges and burdensome transitions was examined with a multivariate mixed-effects logistic model that adjusted for age, gender, race, and hospice primary diagnosis. The model contained an interaction term for year and hospice tax status. Results: The unadjusted overall rate of live discharges increased from 13.7{\%} in 2000 to 18.1{\%} in 2012. For-profit hospice programs had an adjusted live discharge rate of 17.7{\%} in 2000 and 22.7{\%} in 2012. During the same period, the adjusted live discharge rate for nonprofit hospice programs increased from 15.2{\%} to 16.3{\%}. The overall rate of burdensome transitions increased from 2.9{\%} in 2000 to 5.3{\%} in 2012. Similar to the overall rate of live discharge, for-profit hospices had a higher rate of burdensome transitions (6.4{\%}) than nonprofit hospices (4.0{\%}) in 2012. Conclusions: Live hospice discharges and burdensome transitions increased between 2000 and 2012. For-profit hospice programs demonstrated larger increases than nonprofit hospice programs.",
author = "Elizabeth Prsic and Mike Plotzke and Christian, {Thomas J.} and Pedro Gozalo and Joan Teno",
year = "2016",
month = "9",
day = "1",
doi = "10.1089/jpm.2015.0383",
language = "English (US)",
volume = "19",
pages = "987--990",
journal = "Journal of Palliative Medicine",
issn = "1096-6218",
publisher = "Mary Ann Liebert Inc.",
number = "9",

}

TY - JOUR

T1 - A National Study of Live Hospice Discharges between 2000 and 2012

AU - Prsic, Elizabeth

AU - Plotzke, Mike

AU - Christian, Thomas J.

AU - Gozalo, Pedro

AU - Teno, Joan

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background: Live hospice discharges represent a potential vulnerability in the Medicare hospice benefit. Little is known about how live discharges have varied over time. Objective: To identify trends in live hospice discharges between 2000 and 2012. Design, Setting, Patients: Retrospective cohort study of Medicare hospice discharges. Measurements: In this study, we examined live discharges in the first six months of 2000, 2006, 2008, 2010, and 2012. A live discharge was classified as a burdensome transition if hospice discharge was followed by hospital admission, and then there was a hospice readmission within 2 days of hospital discharge. The adjusted rate of overall live discharges and burdensome transitions was examined with a multivariate mixed-effects logistic model that adjusted for age, gender, race, and hospice primary diagnosis. The model contained an interaction term for year and hospice tax status. Results: The unadjusted overall rate of live discharges increased from 13.7% in 2000 to 18.1% in 2012. For-profit hospice programs had an adjusted live discharge rate of 17.7% in 2000 and 22.7% in 2012. During the same period, the adjusted live discharge rate for nonprofit hospice programs increased from 15.2% to 16.3%. The overall rate of burdensome transitions increased from 2.9% in 2000 to 5.3% in 2012. Similar to the overall rate of live discharge, for-profit hospices had a higher rate of burdensome transitions (6.4%) than nonprofit hospices (4.0%) in 2012. Conclusions: Live hospice discharges and burdensome transitions increased between 2000 and 2012. For-profit hospice programs demonstrated larger increases than nonprofit hospice programs.

AB - Background: Live hospice discharges represent a potential vulnerability in the Medicare hospice benefit. Little is known about how live discharges have varied over time. Objective: To identify trends in live hospice discharges between 2000 and 2012. Design, Setting, Patients: Retrospective cohort study of Medicare hospice discharges. Measurements: In this study, we examined live discharges in the first six months of 2000, 2006, 2008, 2010, and 2012. A live discharge was classified as a burdensome transition if hospice discharge was followed by hospital admission, and then there was a hospice readmission within 2 days of hospital discharge. The adjusted rate of overall live discharges and burdensome transitions was examined with a multivariate mixed-effects logistic model that adjusted for age, gender, race, and hospice primary diagnosis. The model contained an interaction term for year and hospice tax status. Results: The unadjusted overall rate of live discharges increased from 13.7% in 2000 to 18.1% in 2012. For-profit hospice programs had an adjusted live discharge rate of 17.7% in 2000 and 22.7% in 2012. During the same period, the adjusted live discharge rate for nonprofit hospice programs increased from 15.2% to 16.3%. The overall rate of burdensome transitions increased from 2.9% in 2000 to 5.3% in 2012. Similar to the overall rate of live discharge, for-profit hospices had a higher rate of burdensome transitions (6.4%) than nonprofit hospices (4.0%) in 2012. Conclusions: Live hospice discharges and burdensome transitions increased between 2000 and 2012. For-profit hospice programs demonstrated larger increases than nonprofit hospice programs.

UR - http://www.scopus.com/inward/record.url?scp=84984706721&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84984706721&partnerID=8YFLogxK

U2 - 10.1089/jpm.2015.0383

DO - 10.1089/jpm.2015.0383

M3 - Article

C2 - 27171543

AN - SCOPUS:84984706721

VL - 19

SP - 987

EP - 990

JO - Journal of Palliative Medicine

JF - Journal of Palliative Medicine

SN - 1096-6218

IS - 9

ER -