Black patients and those with short stays in hospice care are more likely to be readmitted to a hospital after leaving hospice, as found by Rutgers Health researchers in a study published in JAMA Network Open. The study looked at patient outcomes after hospice care to identify factors that lead to transitions.This study found that certain groups of hospice patients, such as racial and ethnic minorities and those with more complex needs, may require extra attention when it comes to discharge planning. Elizabeth Luth, the lead author and a core faculty member at the Center for Healthy Aging Research, emphasized the importance of addressing the needs of these specific patient populations. Approximately 15 percent of hospice patients leave the program before passing away for various reasons, such as unplanned hospitalization, seeking treatment for their terminal condition, transferring to different hospice services, or experiencing stabilization of their condition.
Transitioning to a different care setting can be difficult for a patient’s health. Researchers say that the factors contributing to the risk of difficult transitions out of hospice care have not been well studied, but are important for clinicians and policymakers to understand.
By analyzing Medicare data from over 115,000 patients between 2014 and 2019, the researchers examined various types of challenging transitions out of hospice care. This included patients who were admitted to a hospital after leaving hospice care and patients who passed away while hospitalized. They aimed to evaluate the individual patient, healthcare services, and hospice organization factors.
Various organizational factors are linked to different types of transition outcomes.
A study discovered that Black patients who had shorter stays in hospice and received care from a for-profit hospice service had a higher likelihood of experiencing a burdensome transition after discharge. Around 42% of hospice patients who were discharged passed away within six months, indicating that continuous hospice care may be suitable for many individuals after discharge, according to the researchers.
Inequality in the access to healthcare services and systemic racism are significant contributors to racial and ethnic disparities in health outcomes.The New England Journal of Medicine and The Lancet published previous research indicating that inpatient respite (services offering short-term relief for family caregivers) and general inpatient care (short-term hospital care for symptom management) were linked to reduced chances of hospitalization and hospice readmission. Luth, an assistant, suggested that policymakers should explore making inpatient respite and general inpatient care more readily accessible to families with hospice members who have complex needs in order to improve outcomes after discharge.A professor from the Department of Family Medicine and Community Health at Rutgers Robert Wood Johnson Medical School led the study. The coauthors of the research are Caitlin Brennan and Susan Hurley from Care Dimensions, a hospice and palliative care facility in Massachusetts, Veerawat Phongtankuel, Holly Prigerson, and Yongkang Zhang from Weill Cornell Medicine, Miriam Ryvicker from VNS Health, a nonprofit, community-based health care organization in New York City, and Hui Shao from Emory University.
