Costs of Disenrolling from Hospice Examined

The October edition of the Journal of Clinical Oncology included a study that looked at cancer patients who disenrolled from hospice programs before death. Data from over 90,000 patients served by over 1,300 hospices from 1998 to 2002 were examined. Researchers from Mount Sinai School of Medicine found that patients who left hospice care had medical costs that were five times higher than patients who remained. In addition, they were far more likely to be admitted to a hospital, spend longer in the hospital when admitted, and more likely to visit an emergency department. From the press release:

The study did not investigate why patients disenrolled from hospice care and does not include individuals who were enrolled in a Medicare managed care organization before hospice enrollment. The researchers recommend that future studies include patient and caregiver interviews to help understand the hospice disenrollment process.

"Currently, 39 percent of decedents in this country were under the care of a hospice," continued Dr. Carlson. "Rather than focusing on how to decrease Medicare expenditures by restricting access to the Medicare Hospice Benefit, policy makers should focus on how to decrease the potential barriers to remaining enrolled with hospice until death, with an eye to both decreasing Medicare costs and potentially improving patient and family outcomes."