Acute care hospitals more likely to use feeding tubes on dementia patients from nursing homes, study finds

Advanced dementia patients are more likely to receive feeding tubes if they are taken from nursing homes to acute care hospitals, according to a new report. This occurs despite mounting evidence that using feeding tubes on these patients is not beneficial.

Nursing homes have an incentive to transfer advanced dementia patients on Medicaid to acute care hospitals because Medicare will pay for their care, according to the researchers from Brown University. When this transfer happens, the patients can become stressed, leading hospital staff to prescribe medications and insert feeding tubes, the report suggests. It is more likely that larger, for-profit hospitals will resort to feeding tube use, the researchers found while analyzing a sample of Medicare claims for such patients between 2000 and 2007. On average, there were 7.9 feeding tube insertions per 100 hospitalizations over the period of the study.

A recent study from the Royal College of Physicians found that feeding tube use at the end of life doesn't improve the quality of life or reduce complications. (McKnight's, 1/7/10). Better aligning reimbursement structures to keep advanced dementia patients in less restrictive, more comprehensive care settings may help prevent the need for feeding tubes, the researchers in the latest report suggest. Their report appears in the Feb. 10 edition of the Journal of the American Medical Association.