Can hospices predict which patients will die within six months?

Pamela S. Harris, Tapati Stalam, Kevin A. Ache, Joan E. Harrold, Teresa Craig, Joan Teno, Eugenia Smither, Meredith Dougherty, David Casarett

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: To determine whether it is possible to predict, at the time of hospice enrollment, which patients will die within 6 months. Design: Electronic health record-based retrospective cohort study. Setting: Patients admitted to 10 hospices in the CHOICE network (Coalition of Hospices Organized to Investigate Comparative Effectiveness). Participants: Hospice patients. Main outcome measures: Mortality at 6 months following hospice admission. Results: Among 126,620 patients admitted to 10 hospices, 118,532 (93.6%) died within 6 months. In a multivariable logistic regression model, five characteristics were independent predictors of 6-month mortality. For instance, patients younger than 65 years were less likely to die within 6 months (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.45-0.91; p=0.014). Conversely, male patients were more likely to die within 6 months (OR 1.47; 95% CI 1.05-2.02; p=;0.036). After adjusting for other variables in this model, there were several subgroups with a low probability of 6-month probability (e.g., stroke and Palliative Performance Scale [PPS] score=50; adjusted probability of 6-month mortality=39.4%; 95% CI: 13.9%-72.5%). However, 95% confidence intervals of these 6-month mortality predictions extended above 50%. Conclusions: Hospices might use several variables to identify patients with a relatively low risk for 6-month mortality and who therefore may become ineligible to continue hospice services if they fail to show significant disease progression.

Original languageEnglish (US)
Pages (from-to)894-898
Number of pages5
JournalJournal of palliative medicine
Volume17
Issue number8
DOIs
StatePublished - Aug 1 2014
Externally publishedYes

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Hospices
Mortality
Confidence Intervals
Logistic Models
Odds Ratio
Electronic Health Records
Disease Progression
Cohort Studies
Retrospective Studies
Stroke
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Nursing(all)
  • Anesthesiology and Pain Medicine

Cite this

Harris, P. S., Stalam, T., Ache, K. A., Harrold, J. E., Craig, T., Teno, J., ... Casarett, D. (2014). Can hospices predict which patients will die within six months? Journal of palliative medicine, 17(8), 894-898. https://doi.org/10.1089/jpm.2013.0631

Can hospices predict which patients will die within six months? / Harris, Pamela S.; Stalam, Tapati; Ache, Kevin A.; Harrold, Joan E.; Craig, Teresa; Teno, Joan; Smither, Eugenia; Dougherty, Meredith; Casarett, David.

In: Journal of palliative medicine, Vol. 17, No. 8, 01.08.2014, p. 894-898.

Research output: Contribution to journalArticle

Harris, PS, Stalam, T, Ache, KA, Harrold, JE, Craig, T, Teno, J, Smither, E, Dougherty, M & Casarett, D 2014, 'Can hospices predict which patients will die within six months?', Journal of palliative medicine, vol. 17, no. 8, pp. 894-898. https://doi.org/10.1089/jpm.2013.0631
Harris, Pamela S. ; Stalam, Tapati ; Ache, Kevin A. ; Harrold, Joan E. ; Craig, Teresa ; Teno, Joan ; Smither, Eugenia ; Dougherty, Meredith ; Casarett, David. / Can hospices predict which patients will die within six months?. In: Journal of palliative medicine. 2014 ; Vol. 17, No. 8. pp. 894-898.
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abstract = "Objective: To determine whether it is possible to predict, at the time of hospice enrollment, which patients will die within 6 months. Design: Electronic health record-based retrospective cohort study. Setting: Patients admitted to 10 hospices in the CHOICE network (Coalition of Hospices Organized to Investigate Comparative Effectiveness). Participants: Hospice patients. Main outcome measures: Mortality at 6 months following hospice admission. Results: Among 126,620 patients admitted to 10 hospices, 118,532 (93.6{\%}) died within 6 months. In a multivariable logistic regression model, five characteristics were independent predictors of 6-month mortality. For instance, patients younger than 65 years were less likely to die within 6 months (odds ratio [OR] 0.64; 95{\%} confidence interval [CI] 0.45-0.91; p=0.014). Conversely, male patients were more likely to die within 6 months (OR 1.47; 95{\%} CI 1.05-2.02; p=;0.036). After adjusting for other variables in this model, there were several subgroups with a low probability of 6-month probability (e.g., stroke and Palliative Performance Scale [PPS] score=50; adjusted probability of 6-month mortality=39.4{\%}; 95{\%} CI: 13.9{\%}-72.5{\%}). However, 95{\%} confidence intervals of these 6-month mortality predictions extended above 50{\%}. Conclusions: Hospices might use several variables to identify patients with a relatively low risk for 6-month mortality and who therefore may become ineligible to continue hospice services if they fail to show significant disease progression.",
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AB - Objective: To determine whether it is possible to predict, at the time of hospice enrollment, which patients will die within 6 months. Design: Electronic health record-based retrospective cohort study. Setting: Patients admitted to 10 hospices in the CHOICE network (Coalition of Hospices Organized to Investigate Comparative Effectiveness). Participants: Hospice patients. Main outcome measures: Mortality at 6 months following hospice admission. Results: Among 126,620 patients admitted to 10 hospices, 118,532 (93.6%) died within 6 months. In a multivariable logistic regression model, five characteristics were independent predictors of 6-month mortality. For instance, patients younger than 65 years were less likely to die within 6 months (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.45-0.91; p=0.014). Conversely, male patients were more likely to die within 6 months (OR 1.47; 95% CI 1.05-2.02; p=;0.036). After adjusting for other variables in this model, there were several subgroups with a low probability of 6-month probability (e.g., stroke and Palliative Performance Scale [PPS] score=50; adjusted probability of 6-month mortality=39.4%; 95% CI: 13.9%-72.5%). However, 95% confidence intervals of these 6-month mortality predictions extended above 50%. Conclusions: Hospices might use several variables to identify patients with a relatively low risk for 6-month mortality and who therefore may become ineligible to continue hospice services if they fail to show significant disease progression.

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