Patterns of hospice use in patients dying from hematologic malignancies

Amy Sexauer, M. Jennifer Cheng, Louise Knight, Anthony W. Riley, Lauren King, Thomas J Smith

Research output: Contribution to journalArticle

Abstract

Background: Hospice brings substantial clinical benefits to dying patients and families but is underutilized by patients dying of hematologic malignancies (HM); nationwide, only 2% of HM patients use hospice. There are 70,000 deaths among U.S. patients with hematologic malignancies yearly. Objective: We measured the use and length of stay (LOS) in hospice among patients with HMs at a large academic cancer center. Design: This was a single center retrospective review of adult patients (≥18 years) with lymphoma, leukemia, myelodysplastic syndrome, aplastic anemia, and multiple myeloma referred for hospice. Measurements: Information included demographics, transplant, hospice type, LOS, and use of "expanded access" services. Results: Fifty-nine patients were referred to hospice, and 53 utilized hospice services, 25% of 209 HM decedents. Thirty-five received home hospice and 18 used inpatient hospice. The median home hospice LOS was nine days (SD 13) and inpatient hospice six days (SD 10). Nine patients with "expanded access" hospice received only a few blood transfusions, and none received radiation. Conclusions: HM patients are referred late or never for hospice services. Studies evaluating earlier integration of palliative and hospice care with usual HM care are warranted. We present a one-page negotiation form that we have found useful in negotiations among HM physicians, hospice medical directors, and payers.

Original languageEnglish (US)
Pages (from-to)195-199
Number of pages5
JournalJournal of Palliative Medicine
Volume17
Issue number2
DOIs
StatePublished - Feb 1 2014

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Hospices
Hematologic Neoplasms
Length of Stay
Negotiating
Inpatients
Physician Executives
Hospice Care
Aplastic Anemia
Myelodysplastic Syndromes
Multiple Myeloma
Palliative Care
Blood Transfusion

ASJC Scopus subject areas

  • Medicine(all)
  • Anesthesiology and Pain Medicine
  • Nursing(all)

Cite this

Patterns of hospice use in patients dying from hematologic malignancies. / Sexauer, Amy; Cheng, M. Jennifer; Knight, Louise; Riley, Anthony W.; King, Lauren; Smith, Thomas J.

In: Journal of Palliative Medicine, Vol. 17, No. 2, 01.02.2014, p. 195-199.

Research output: Contribution to journalArticle

Sexauer, Amy ; Cheng, M. Jennifer ; Knight, Louise ; Riley, Anthony W. ; King, Lauren ; Smith, Thomas J. / Patterns of hospice use in patients dying from hematologic malignancies. In: Journal of Palliative Medicine. 2014 ; Vol. 17, No. 2. pp. 195-199.
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