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Place of Death of Individuals with Terminal Cancer: New Insights from Medicare Hospice Place-of-Service Codes.
- Source :
- Journal of the American Geriatrics Society; Sep2016, Vol. 64 Issue 9, p1815-1822, 8p, 3 Charts, 1 Graph
- Publication Year :
- 2016
-
Abstract
- Objectives To use place-of-service ( POS) codes in the Medicare hospice claims files to document where elderly hospice users with cancer die. Design Retrospective cohort study. Setting Surveillance, Epidemiology, and End Results ( SEER) cancer registry areas. Participants Elderly Medicare beneficiaries who died of lung, breast, colorectal, or pancreatic cancer in 2007 and 2008 (N = 46,037). Measurement Use of hospice, place of service at death (home, nursing home, hospital, inpatient hospice, other), length of stay in hospice. Results Two-thirds of the beneficiaries used hospice. Younger, male, black, Asian, and unmarried beneficiaries and those enrolled in fee-for-service Medicare or from areas with lower income were less likely to use hospice. Hospice enrollment also varied significantly according to SEER registry. Thirty percent of the hospice users were not receiving home-based care at the time of death, and 17% were enrolled for less than 3 days. Factors associated with hospice death in the home mirrored those associated with hospice use. Individuals dying in hospitals (odds ratio ( OR) = 5.13, 95% confidence interval ( CI) = 4.63-5.69), inpatient hospice ( OR = 1.86, 95% CI = 1.70-2.02), and nursing homes ( OR = 1.19, 95% CI = 1.10-1.28) had greater odds of a short hospice stay (≤7 days) than those dying at home, after controlling for all other measured factors, whereas those dying in nursing homes had greater odds of long stays (>180 days) ( OR = 1.46, 95% CI = 1.28-1.67). Conclusion New hospice POS codes are useful for understanding place of death for hospice users. Hospice deaths cannot be assumed to happen at home. [ABSTRACT FROM AUTHOR]
- Subjects :
- PLACE of death
HOSPICE care
CANCER patient care
MEDICAL coding
HOSPICE patients
MEDICARE beneficiaries
RETROSPECTIVE studies
TERMINALLY ill
MEDICAL care
AGE distribution
ASIANS
BLACK people
CANCER patients
CHI-squared test
CONFIDENCE intervals
DEATH
ECOLOGY
LENGTH of stay in hospitals
HOSPITALS
INCOME
MARITAL status
NURSING care facilities
PROBABILITY theory
RACE
SEX distribution
TERMINAL care
TUMORS
HOME environment
MULTIPLE regression analysis
SOCIOECONOMIC factors
DATA analysis software
DESCRIPTIVE statistics
ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 00028614
- Volume :
- 64
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Journal of the American Geriatrics Society
- Publication Type :
- Academic Journal
- Accession number :
- 118169804
- Full Text :
- https://doi.org/10.1111/jgs.14269