Quality of hospice care for individuals with dementia

Jennifer S. Albrecht, Ann L. Gruber-Baldini, Erik Fromme, Jessina C. McGregor, David S H Lee, Jon P. Furuno

    Research output: Contribution to journalArticle

    19 Citations (Scopus)

    Abstract

    Background Patients with dementia constitute an increasing proportion of hospice enrollees, yet little is known about the quality of hospice care for this population. The aim of this study was to quantify differences in quality of care measures between hospice patients with and without dementia. Design Cross-sectional analysis of data. Setting 2007 National Home and Hospice Care Survey. Participants Four thousand seven hundred eleven discharges from hospice care. Measurements A primary diagnosis of dementia at discharge was defined according to International Classification of Diseases, Ninth Revision, codes (290.0-290.4x, 294.0, 294.1, 294.8, 331.0-331.2, 331.7, and 331.8). Quality-of-care measures included enrollment in hospice in the last 3 days of life, receiving tube feeding, depression, receiving antibiotics, lack of advanced directive or do not resuscitate order, Stage II or greater pressure ulcers, emergency care, lack of continuity of residence, and a report of pain at last assessment. Results Four hundred fifty (9.5%) individuals were discharged with a primary diagnosis of dementia. In multivariable analysis, individuals with dementia were more likely to receive tube feeding (odds ratio (OR) = 2.6, 95% confidence interval (CI) = 1.4-4.5) and to have greater continuity of residence (OR = 1.8, 95% CI = 1.1-3.0) than other individuals in hospice and less likely to have a report of pain at last assessment (OR = 0.6, 95% CI = 0.3-0.9). Conclusions The majority of quality-of-care measures examined did not differ between individuals in hospice with and without dementia. Use of tube feeding in hospice care and methods of pain assessment and treatment in individuals with dementia should be considered as potential quality-of-care measures.

    Original languageEnglish (US)
    Pages (from-to)1060-1065
    Number of pages6
    JournalJournal of the American Geriatrics Society
    Volume61
    Issue number7
    DOIs
    StatePublished - Jul 2013

    Fingerprint

    Hospice Care
    Quality of Health Care
    Dementia
    Hospices
    Enteral Nutrition
    Odds Ratio
    Confidence Intervals
    Resuscitation Orders
    Pain
    Pressure Ulcer
    Emergency Medical Services
    International Classification of Diseases
    Pain Measurement
    Home Care Services
    Cross-Sectional Studies
    Depression
    Anti-Bacterial Agents
    Population

    Keywords

    • dementia
    • hospice and palliative medicine
    • NHHCS
    • quality of care

    ASJC Scopus subject areas

    • Geriatrics and Gerontology

    Cite this

    Albrecht, J. S., Gruber-Baldini, A. L., Fromme, E., McGregor, J. C., Lee, D. S. H., & Furuno, J. P. (2013). Quality of hospice care for individuals with dementia. Journal of the American Geriatrics Society, 61(7), 1060-1065. https://doi.org/10.1111/jgs.12316

    Quality of hospice care for individuals with dementia. / Albrecht, Jennifer S.; Gruber-Baldini, Ann L.; Fromme, Erik; McGregor, Jessina C.; Lee, David S H; Furuno, Jon P.

    In: Journal of the American Geriatrics Society, Vol. 61, No. 7, 07.2013, p. 1060-1065.

    Research output: Contribution to journalArticle

    Albrecht, JS, Gruber-Baldini, AL, Fromme, E, McGregor, JC, Lee, DSH & Furuno, JP 2013, 'Quality of hospice care for individuals with dementia', Journal of the American Geriatrics Society, vol. 61, no. 7, pp. 1060-1065. https://doi.org/10.1111/jgs.12316
    Albrecht JS, Gruber-Baldini AL, Fromme E, McGregor JC, Lee DSH, Furuno JP. Quality of hospice care for individuals with dementia. Journal of the American Geriatrics Society. 2013 Jul;61(7):1060-1065. https://doi.org/10.1111/jgs.12316
    Albrecht, Jennifer S. ; Gruber-Baldini, Ann L. ; Fromme, Erik ; McGregor, Jessina C. ; Lee, David S H ; Furuno, Jon P. / Quality of hospice care for individuals with dementia. In: Journal of the American Geriatrics Society. 2013 ; Vol. 61, No. 7. pp. 1060-1065.
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    abstract = "Background Patients with dementia constitute an increasing proportion of hospice enrollees, yet little is known about the quality of hospice care for this population. The aim of this study was to quantify differences in quality of care measures between hospice patients with and without dementia. Design Cross-sectional analysis of data. Setting 2007 National Home and Hospice Care Survey. Participants Four thousand seven hundred eleven discharges from hospice care. Measurements A primary diagnosis of dementia at discharge was defined according to International Classification of Diseases, Ninth Revision, codes (290.0-290.4x, 294.0, 294.1, 294.8, 331.0-331.2, 331.7, and 331.8). Quality-of-care measures included enrollment in hospice in the last 3 days of life, receiving tube feeding, depression, receiving antibiotics, lack of advanced directive or do not resuscitate order, Stage II or greater pressure ulcers, emergency care, lack of continuity of residence, and a report of pain at last assessment. Results Four hundred fifty (9.5{\%}) individuals were discharged with a primary diagnosis of dementia. In multivariable analysis, individuals with dementia were more likely to receive tube feeding (odds ratio (OR) = 2.6, 95{\%} confidence interval (CI) = 1.4-4.5) and to have greater continuity of residence (OR = 1.8, 95{\%} CI = 1.1-3.0) than other individuals in hospice and less likely to have a report of pain at last assessment (OR = 0.6, 95{\%} CI = 0.3-0.9). Conclusions The majority of quality-of-care measures examined did not differ between individuals in hospice with and without dementia. Use of tube feeding in hospice care and methods of pain assessment and treatment in individuals with dementia should be considered as potential quality-of-care measures.",
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    N2 - Background Patients with dementia constitute an increasing proportion of hospice enrollees, yet little is known about the quality of hospice care for this population. The aim of this study was to quantify differences in quality of care measures between hospice patients with and without dementia. Design Cross-sectional analysis of data. Setting 2007 National Home and Hospice Care Survey. Participants Four thousand seven hundred eleven discharges from hospice care. Measurements A primary diagnosis of dementia at discharge was defined according to International Classification of Diseases, Ninth Revision, codes (290.0-290.4x, 294.0, 294.1, 294.8, 331.0-331.2, 331.7, and 331.8). Quality-of-care measures included enrollment in hospice in the last 3 days of life, receiving tube feeding, depression, receiving antibiotics, lack of advanced directive or do not resuscitate order, Stage II or greater pressure ulcers, emergency care, lack of continuity of residence, and a report of pain at last assessment. Results Four hundred fifty (9.5%) individuals were discharged with a primary diagnosis of dementia. In multivariable analysis, individuals with dementia were more likely to receive tube feeding (odds ratio (OR) = 2.6, 95% confidence interval (CI) = 1.4-4.5) and to have greater continuity of residence (OR = 1.8, 95% CI = 1.1-3.0) than other individuals in hospice and less likely to have a report of pain at last assessment (OR = 0.6, 95% CI = 0.3-0.9). Conclusions The majority of quality-of-care measures examined did not differ between individuals in hospice with and without dementia. Use of tube feeding in hospice care and methods of pain assessment and treatment in individuals with dementia should be considered as potential quality-of-care measures.

    AB - Background Patients with dementia constitute an increasing proportion of hospice enrollees, yet little is known about the quality of hospice care for this population. The aim of this study was to quantify differences in quality of care measures between hospice patients with and without dementia. Design Cross-sectional analysis of data. Setting 2007 National Home and Hospice Care Survey. Participants Four thousand seven hundred eleven discharges from hospice care. Measurements A primary diagnosis of dementia at discharge was defined according to International Classification of Diseases, Ninth Revision, codes (290.0-290.4x, 294.0, 294.1, 294.8, 331.0-331.2, 331.7, and 331.8). Quality-of-care measures included enrollment in hospice in the last 3 days of life, receiving tube feeding, depression, receiving antibiotics, lack of advanced directive or do not resuscitate order, Stage II or greater pressure ulcers, emergency care, lack of continuity of residence, and a report of pain at last assessment. Results Four hundred fifty (9.5%) individuals were discharged with a primary diagnosis of dementia. In multivariable analysis, individuals with dementia were more likely to receive tube feeding (odds ratio (OR) = 2.6, 95% confidence interval (CI) = 1.4-4.5) and to have greater continuity of residence (OR = 1.8, 95% CI = 1.1-3.0) than other individuals in hospice and less likely to have a report of pain at last assessment (OR = 0.6, 95% CI = 0.3-0.9). Conclusions The majority of quality-of-care measures examined did not differ between individuals in hospice with and without dementia. Use of tube feeding in hospice care and methods of pain assessment and treatment in individuals with dementia should be considered as potential quality-of-care measures.

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