Survival of Medicare Patients After Enrollment in Hospice Programs

Published in: The New England Journal of Medicine, v. 335, no. 3, July 18, 1996, p. 172-178

Posted on RAND.org on January 01, 1996

by Nicholas A. Christakis, Jose J. Escarce

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Each year more than 220,000 Medicare beneficiaries receive care from hospice programs designed to enhance the quality of the end of life. Enrollment requires certification by a physician that the patient has a life expectancy of less than six months. The authors examined how long before death patients enrolled in hospice programs. Using 1990 Medicare claims data, they analyzed the characteristics and survival of 6,451 hospice patients followed for a minimum of 27 months with respect to mortality. The authors conclude that most patients who enter hospice care do so late in the course of their terminal illnesses. The timing of enrollment in hospice programs varies substantially with the characteristics of the patients and the hospices.

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