Hospice utilization among Medicare beneficiaries dying from pancreatic cancer.

Abstract:

BACKGROUND:Use of hospice services among patients with pancreatic cancer following pancreatic resection remains unknown. METHODS:Patients with pancreatic cancer who underwent resection were identified in the Medicare Standard Analytic Files. Outcomes included overall hospice use, early hospice enrollment (≥4 weeks before death), late hospice enrollment (initiation within 3 days of death), and Medicare expenditures. RESULTS:Among the 4369 deceased individuals, three-fourths of patients (n = 3252, 74.4%) used hospice at the time of death. Patients who did not use hospice were more likely to be male, have a complication on index admission and receive life sustaining treatments on subsequent admissions (P < .05). Only one-third (32.2%) of patients initiated hospice services early. Medicare expenditure during the last month of life was $10 000 lower among patients who initialized hospice services at least 1 month before death versus within 3 days of death (late: $10 581 [$5454-$17 200], early: $221 [$46-$733]; P < .001) CONCLUSION: While three-fourths of patients utilized hospice services after pancreatic resection, only one-third of patients initiated hospice services at least one-month before death. Late hospice use was associated with higher Medicare expenditures during the last month of life. Further research is needed to understand barriers to early hospice utilization.

journal_name

J Surg Oncol

authors

Paredes AZ,Hyer JM,Tsilimigras DI,Mehta R,Sahara K,White S,Dillhoff ME,Ejaz A,Cloyd JM,Pawlik TM

doi

10.1002/jso.25623

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

624-631

issue

4

eissn

0022-4790

issn

1096-9098

journal_volume

120

pub_type

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