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- Title
Association Between Nursing Visits and Hospital-Related Disenrollment in the Home Hospice Population.
- Authors
Phongtankuel, Veerawat; Adelman, Ronald D.; Trevino, Kelly; Abramson, Erika; Johnson, Phyllis; Oromendia, Clara; Henderson, Charles R.; Reid, M. C.
- Abstract
Background: Over 10% of hospice patients experience a transition out of hospice care during the last months of life. Hospice transitions from home to hospital (ie, hospital-related hospice disenrollment) result in fragmented care, which can be burdensome for patients and caregivers. Nurses play a major role in delivering home hospice care, yet little is known about the association between nursing visits and disenrollment. Objectives: The study’s purpose is to examine the association between the average number of nursing visits per week and hospital-related disenrollment in the home hospice population. We hypothesize that more nursing visits per week will be associated with reduced odds for disenrollment. Design: A retrospective cohort study using Medicare data. Participants: Medicare hospice beneficiaries who were ≥18 years old in 2012. Outcome measured: Hospitalization within 2 days of hospice disenrollment. Results: The sample included 115 103 home hospice patients, 6450 (5.6%) of whom experienced a hospital-related disenrollment. The median number of nursing visits per week was 2 (interquartile range 1.3-3.2), with a mean of 2.5 (standard deviation ±1.6). There was a decreased likelihood of a hospital-related disenrollment when comparing enrollments that had <3 nursing visits per week on average to 3 to <4 visits (odds ratio [OR] 0.39; P value <.001), 4 to <5 visits (OR 0.29; P value <.001), and 5+ visits (OR 0.21; P value <.001). Conclusions: More nursing visits per week was associated with a decreased likelihood of a hospital-related hospice disenrollment. Further research is needed to understand what components of nursing care influence care transitions in the home hospice setting.
- Subjects
CHI-squared test; CONFIDENCE intervals; HOME care services; HOSPICE care; LENGTH of stay in hospitals; LONGITUDINAL method; MULTIVARIATE analysis; NURSING specialties; PATIENTS; RESEARCH funding; STATISTICAL sampling; STATISTICS; HOSPICE nurses; LOGISTIC regression analysis; RETROSPECTIVE studies; RECEIVER operating characteristic curves; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio; MANN Whitney U Test
- Publication
American Journal of Hospice & Palliative Medicine, 2018, Vol 35, Issue 2, p316
- ISSN
1049-9091
- Publication type
Article
- DOI
10.1177/1049909117697933