Media type: E-Article Title: Hospice eligibility in patients who died in a tertiary care center Contributor: Freund, Katherine; Weckmann, Michelle T.; Casarett, David J.; Swanson, Kristi; Brooks, Mary Kay; Broderick, Ann imprint: Wiley, 2012 Published in: Journal of Hospital Medicine Language: English DOI: 10.1002/jhm.975 ISSN: 1553-5592; 1553-5606 Keywords: Assessment and Diagnosis ; Care Planning ; Health Policy ; Fundamentals and skills ; General Medicine ; Leadership and Management Origination: Footnote: Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND:</jats:title><jats:p>Hospice is a service that patients, families, and physicians find beneficial, yet a majority of patients die without receiving hospice care. Little is known about how many hospitalized patients are hospice eligible at the time of hospitalization.</jats:p></jats:sec><jats:sec><jats:title>METHODS:</jats:title><jats:p>Retrospective chart review was used to examine all adult deaths (n = 688) at a tertiary care center during 2009. Charts were selected for full review if the death was nontraumatic and the patient had a hospital admission within 12 months of the terminal admission. The charts were examined for hospice eligibility based on medical criteria, evidence of a hospice discussion, and hospice enrollment.</jats:p></jats:sec><jats:sec><jats:title>RESULTS:</jats:title><jats:p>Two hundred nine patients had an admission in the year preceding the terminal admission and a nontraumatic death. Sixty percent were hospice eligible during the penultimate admission. Hospice discussions were documented in 14% of the hospice‐eligible patients. Patients who were hospice eligible had more subspecialty consults on the penultimate admission compared to those not hospice eligible (<jats:italic>P</jats:italic> = 0.016), as well as more overall hospitalizations in the 12 months preceding their terminal admission (<jats:italic>P</jats:italic> = 0.0003), and fewer days between their penultimate admission and death (<jats:italic>P</jats:italic> = 0.001).</jats:p></jats:sec><jats:sec><jats:title>CONCLUSION:</jats:title><jats:p>The majority of terminally ill inpatients did not have a documented discussion of hospice with their care provider. Educating physicians to recognize the stepwise decline of most illnesses and hospice admission criteria will facilitate a more informed decision‐making process for patients and their families. A consistent commitment to offer hospice earlier than the terminal admission would increase access to community or home‐based care, potentially increasing quality of life. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine.</jats:p></jats:sec>